Inspection on 21/01/09 for 109 Higham Road

This inspection was carried out on 21st January 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

109 Higham Road 15/01/08

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

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/06/2011.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 109 Higham Road 109 Higham Road Rushden Northants NN8 3AA one star adequate service The quality rating for this care home is: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Williamson Date: 2 1 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area Outcome area (for example: Choice of home) These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Internet address www.csci.org.uk Information about the care home Name of care home: Address: 109 Higham Road 109 Higham Road Rushden Northants NN8 3AA 01933358429 01933358606 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Care Management Group Ltd (trading as CMG Homes Ltd) care home 6 Number of places (if applicable): Under 65 Over 65 6 0 learning disability Additional conditions: To include 2 service users over the age of 65 years LD(E) Date of last inspection 1 5 0 1 2 0 0 8 A bit about the care home 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. Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: one star adequate service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home How we did our inspection: This is what the inspector did when they were at the care home The focus of inspections is on outcomes for Service Users and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case two Service Users were chosen. This visit took place over one day, commencing at 10.30pm and took five hours to complete. An opportunity was taken to talk with the Manager, staff and Service Users look around the home, view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment, which gives information on the Service Users, home and the staff group. Two staff were spoken with, and six Service Users were seen, and their interactions with the staff group observed. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. What the care home does well Service Users care needs are assessed and a plan of care produced to enable staff to support people. Complaints information is readily available in the home, this is backed up by details of advocates and others who would act on peoples behalf. Some of these documents are produced in an easy read format using pictures and symbols. Checks on medication and health care visits are regularly performed, this indicates a good degree of staff protection for people in the home. Service Users time during the week is taken up by college courses, social care and some employment. A programme of entertainment is in place and Service Users have the flexibility to choose from a range of pastimes on a group and individual basis. There is a planned menu, and Service Users have a number of alternative choices of food. People are aware of safeguarding, and how the whistleblowing procedure works. Supervision, which are meetings between the manager and staff on a one to one basis, is still ongoing as are the staff meetings. What has got better from the last inspection What the care home could do better The complaints information must be updated to enable all who use it, to be assured of having the correct contact details. Risk assesments must be put in place, and where in place reassessed periodically to ensure the safety of people in the home. Health monitoring by staff must be regulated, and when necessary followed up to ensure the best possible treatment for those staying in the home. Prior to staff being employed in the home the full range of checks and information to ensure peoples safety, must be completed. Periodic checks on the health and safety systems in the home, must be overseen to ensure they are continual and ongoing; and where deficiencies occur these are followed up appropriately. If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact Keith Williamson CPCI Capital Park Fulbourn Cambridge 01223 771300 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . A thorough assessment procedure ensures that service users needs are effectively met. Evidence: The service users assessment information was well detailed and contained information relating to their needs and abilities. This is important as this information forms the basis for any plan of care. All of the assessment information was up to date, though and accurately reflected their current abilities. Both people had contracts in place. These documents are important to signify the terms and conditions of the stay. Discussion with the registered manager and staff indicated that the assessment process was detailed and backed up by a checklist to confirm all the process had been undertaken. This indicates that staff have good levels of safety built in to the assessment process, by assuring all points are covered in the list. The Service User Guide and Statement of Purpose, which are documents giving information about the home. These are used in the admission process, to give information to prospective people coming into the home. Some of the information needs to be updated to ensure anyone using the documents has the correct contact information of the CSCI and details on the Local Authoritys complaints process. The outcomes of the most recent Quality Assurance questionnaires have yet to be added to the documents given to prospective Service Users to the home. Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Care plans are detailed and ensure staff are aware how best to assist service users. Risk assessments are not fully in place, and therefore do not ensure staff have taken reasonable steps to reduce dangers posed to service users. Evidence: The Residents support plan were examined these like the assessment information was well detailed and covered areas in their daily life. The plan was written in a person centred way, and was directly linked to the information in the assessment. The care plans were signed by the resident, indicating their agreement with the content. Staff responsibilities for meeting various aspects of the plan were clearly identified and there was evidence that the information was regularly reviewed. The care plans were backed up by risk assessments. Some areas and topics were not covered, so did not give staff the instruction on how to care for people safely. For example traveling in a car was covered, but not leaving the home to go to the shops. Clear risk assessments are needed to ensure the safety of people in the home. Records are completed on a daily basis covering various activities and the residents responses. Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . People at the home experience good lifestyle choices. Evidence: Service Users personal development is detailed in their personal care plan. This is produced in a form useful to them, some being in pictorial form. This indicates the staff communicate effectively with the people in the home. Service Users take part in leisure activities both within and out of the home. Staff indicated on the day that there was enough materials, games and pastimes to allow these sessions on a regular basis. Evidence suggests Service Users have a range of choices offered to them. These choices cover activities, meals, menus and outings and are usually discussed at the regular Service Users meetings. The planning of meals is an area, where Service Users have a direct input, where meals are planned around peoples likes and dislikes. This is in the form of a list in the Service Users file, and is updated regularly. Service Users have the option of a bedroom key, though not all have taken up this offer. Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents personal care and medication needs are well met with a well informed staff group. Deficiences in the recording and monitoring of residents health needs are not followed up appropriately, placing people at risk in the home. Evidence: Service Users personal care and support needs are clearly detailed in their care plan; this is detailed and indicates likes and dislikes such as which staff members they preferred to receive support from. Service Users also have information in their plan of care, about their health management and have regular access to dental and optical services. Other specialists such as psychiatrists, psychologists and speech and language therapy staff also have input with individual residents. This is important as it shows the home cares for peoples greater health needs. However some of the information in the records is not acted on appropriately. One person had a regular check on their weight, but the record was not completed for a significant period of time. There was a significant unplanned weight loss, which was not followed up by staff. This places Service Users at risk of potential medical conditions not being followed up. Medication is safely administered, with a senior member of staff overseeing the regular audits and day to day checks in place, so ensuring peoples safety in the home. Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents are protected by policies, procedures and a well informed staff group. Evidence: There have been no complaints forwarded to the Commission for Social Care Inspection with regard to the home. The complaints recorded by staff, were prior to the last visit to the home, and were dealt with promptly. Complaints information is clearly displayed in the Service User Guide, and in the home, as well as being available in a pictorial version. This will help the current Service User group in making a complaint if they so wish. Information on advocates and advocacy services are also freely available in the home. The information enclosed in the complaint documents is not accurate, and needs to be updated. This shall give the correct information for people to act on. Service Users and staff told the Inspector what they knew about the complaints, adult protection and whistleblowing procedures. They all showed a good understanding of the process involved in following such issues through. Service Users are also involved in training sessions on protection issues. Records around the recording of Service Users personal allowances were viewed these were accurate with the receipts in place to confirm what purchases have been made. Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Residents live in an environment that is homely, comfortable and clean. Evidence: The general decor in the home is good with the ground floor shower room being tiled at the time of the visit. The manager also showed the Inspector the recently completed re-fitted kitchen. Though there is currently no maintenance and refurbishment plan for the home, it is clear that items and areas within the home are updated and redecorated on a regular basis. The Service Users bedrooms are personalised, with various pictures furniture and electrical equipment. One of the floor coverings is in a poor state, and needs replacing promptly. Staff were aware of cross contamination and cross infection issues, and agreed that there were plentiful supplies of protective clothing. This is important as it protects people in the home. Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Recruitment proceures need to be more efficient as small deficiences in the process leave people at risk in the home. Evidence: Staffing levels reflect the Service Users level of need and enable individual support throughout the day and night. A comprehensive programme of staff training is in place with courses being planned on an ongoing basis. Staff were confident about the content of the training they received, would allow them to transfer that knowledge into the workplace. Training is arranged through private and public providers, and in conjunction with other homes in the group, and leads to staff gaining proffessional qualifications. Staff recruitment records were examined; these were up to date but one recent employee had no reference from their last employer. This places people in the home at risk. Other file contained the appropriate checks required prior to staff commencing employment. Staff supervision which is meetings between staff and the management of the home, is undertaken regularly and assists in the planning of staff training. This is important as it means staff are viewed on an individual basis, and the appropriate training planned accordingly. Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service . Deficiences in the provision of risk associated written materiels, and the regular testing of safety areas leave people at risk in the home. Evidence: The current manager is registered with the Commission for Social Care Inspection (CSCI)and has a wealth of experience as a care professional. Quality Assurance (QA) which is the way the homes success is measured, is seen as important with questionnaires and meetings with Service Users taking place on a regular basis. A number of these are completed by an independent person appointed by the company. This is good as the findings are independent of the homes staff group. Visits are made by the regional director and other senior managers within the company, to oversee the development of the manager and staff in the home, this is yet another area of Quality Assurance. The policies and procedures in the home are developed and updated on a regular basis by the head office of the company. They are stored in the office of the home, and staff were aware of their content. However these are not in an easily used order, and staff could find difficulty in using these in an emergency. A computer system is currently being installed which should enable easier access to updated versions of these, and other documents. The safety within the home is poor, with a lack of regular and detailed checks being performed on the fire and evacuation system within the home. The kitchen has been replaced recently, and provides safe storage for cleaning materials and other Control of Substances Hazardous to Health (COSHH). However the COSHH data sheets, which are used in case of an emergency involving chemicals stored in the home, are stored Evidence: in the laundry. This is outside the home, and the written information was in a very poor state, some being illegible and no use in the treatment of any emergency involving those in the home. One requirement made at the last visit, was for the front entrance steps of the home, to have a specific risk assesment to ensure the safety of service users, staff and visitors to the home. This has not been done and therefore has been re-entered in this report. Risk assesments for the radiators in the home, have been completed and covers supplied as required. Are there any outstanding requirements from the last inspection? Yes  No  Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No Standard Regulation Requirement Timescale for action 1 42 13 (4) 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. 28/02/2008 Requirements and recommendations from this inspection Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No Standard Regulation Description Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set No Standard Regulation Description Timescale for action 1 1 6 Information used in the admission process must be brought up to date. 06/04/2009 This is to ensure any person using the information, has the correct details. 2 7 12 The registered manager must ensure that the appropriate risks are identified, and steps put in place to inform staff how to reduce those risks. 03/04/2009 This to ensure that residents are protected by the appropriate risk strategies being in place. 3 19 13 The Responsible Person must 03/04/2009 ensure that where monitoring of peoples well being that appropriate action to deal with deficiences in a persons condition are dealt with appropraitely. This is to ensure deteriorating conditions are detected and the appropriate follow up action taken. 4 34 19 The registered individual must ensure that the recruitment process is followed and all references obtained prior to staff commencing work in the home. 03/04/2009 Thhis is to ensure the safety of people in the home. 5 42 23 The responsible person must 10/04/2009 ensure the take adequate precautions to ensure that health and safety issues are appropriately dealt with. This is to ensure the safety of people in the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. 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