Inspection on 17/06/09 for 119 Victoria Street

This inspection was carried out on 17th June 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

119 Victoria Street 19/06/08

119 Victoria Street 22/06/07

119 Victoria Street 13/06/06

119 Victoria Street 25/02/06

119 Victoria Street 20/09/05

119 Victoria Street 23/03/05

119 Victoria Street 23/03/05

119 Victoria Street 23/03/05

119 Victoria Street 23/03/05

119 Victoria Street 13/04/04

119 Victoria Street 13/04/04

119 Victoria Street 13/04/04

119 Victoria Street 13/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 12/10/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 119 Victoria Street 119 Victoria Street Cinderford Gloucestershire GL14 2HU     The quality rating for this care home is:   one star adequate service 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: Simon Massey     Date: 1 7 0 6 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. that people have said are important to them: They reflect the things 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. Care Homes for Adults (18-65 years) Page 2 of 25 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. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home Name of care home: Address: 119 Victoria Street 119 Victoria Street Cinderford Gloucestershire GL14 2HU 01594516582 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): appleorchard1@btinternet.com Mrs Beverley Mills,Mr Thomas Alfred Mills Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 3 Number of places (if applicable): Under 65 Over 65 0 learning disability Additional conditions: Date of last inspection Brief description of the care home 3 119 Victoria Street is a terraced house on the outskirts of Cinderford. Care and accommodation are provided for three people with learning disabilities. Support and staffing levels are minimal and the home aims to help service users to develop their independent living skills. Service Users each have their own room. In addition there is a lounge, bathroom and kitchen. A smaller room upstairs is used as an office. There is a garden with a patio at the back of the house and a small front garden. The home has close links with another nearby home, which is operated by the same providers and run by the same manager. Service users move on from there to 119 Victoria Street when they are assessed as able to manage more independently, rather than being directly referred to the home. The home?s Statement of Purpose and Service User Guide provide information as to the services that the home provides. The current fee range for the home is between #307.50 and #859.34 per week. Care Homes for Adults (18-65 years) Page 4 of 25 Care Homes for Adults (18-65 years) Page 5 of 25 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 peterchart Poor Adequate Good Excellent How we did our inspection: This inspection was undertaken on 17/06/09. The Inspector met with the Registered Provider, the Acting Manager and also the senior carer who currently has responsibility for running the service. The Inspector also met with the three people who live at the home. For the majority of the time the service was unstaffed during this visit, as the people live in the home semi independently. This meant that some records relating to the running of the home were unavailable during the visit. Records relating to medication, health and safety, care planning and staff recruitment were examined and also an inspection of the environment was carried out. The Inspector is grateful to the people using the service for their friendly and helpful approach to the inspection process. Care Homes for Adults (18-65 years) Page 6 of 25 Care Homes for Adults (18-65 years) Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 25 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 Care Homes for Adults (18-65 years) Page 9 of 25 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Review and revision of the Statement of Purpose may benefit service users by presenting a more accurate and appropriate picture of the service. The admission procedure ensures that peoples needs and aspirations are assessed prior to prospective residents moving into the home Evidence: There have been no admissions to the home in recent years. The service has an admission policy that complies with the regulations. The Service User Guide has been updated and a copy was available in the home but there is a need to update and review the Statement of Purpose. These documents could also be presented in different formats that would may promote better understanding for some potential users of the service. Care Homes for Adults (18-65 years) Page 10 of 25 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. A good start has been made in producing person centered plans to identify individual needs and aspirations with the full involvement of the people living in the home. An effective reviewing system and more structure around independence skills training could produce better outcomes for people. Evidence: The service has introduced a new person centered planning system and copies of these plans were seen at the inspection. These contain detailed information on a wide range of needs and issues. These also included information about behavior management. The plans were all signed by the people living in the home to verify they were happy with what had been recorded. People demonstrated a good understanding of their plans but were a little unclear about how they would be reviewing and changing them. They were positive about their involvement in writing the plans. There is scope to develop more detailed goals and objectives around independence but people were able to describe various targets they were working towards. Some of the recording around the Care Homes for Adults (18-65 years) Page 11 of 25 Evidence: care plans was not available during this visit but it was explained there is a daily recording system in which people living in the home can write. It was explained about a system of Learning Logs, which will record progress made towards identified goals around independence. These records were not available at the time of this visit. There were risk assessments in place but some of these were in need of reviewing and updating. Everyone living in the home has been assessed as being able to go out independently in the community and being unsupervised in the home. Care Homes for Adults (18-65 years) Page 12 of 25 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. The home supports people using the service to develop individual lifestyles and plan for the future by encouraging the development of independence skills. Service users appear confident about their right to make choices and decisions about their lives. Service users are encouraged to eat healthily but their right to choose is respected by the staff team. Evidence: Two of the people living in the home were very positive about their daily activities and felt they had enough to do at all times. The third person is in the process of having some new activities organized and was positive about the possibilities, but said they were a little bored at times at the moment. These plans were also explained to the inspector by the senior worker. It is planned to provide a more structured routine of Care Homes for Adults (18-65 years) Page 13 of 25 Evidence: activities that will better meet their needs. People described the holiday they had been on earlier in the year and all said that this had been a great success. They also described a holiday abroad that is planned for later in the year which they were all looking forward to. People gave a variety of examples of social activities that they are involved and all were positive about these and the independence that living in the home gives them. The Inspector was shown a list the service users had written themselves, with staff support, which listed the key points about independent living that were important to them. People said they had had occasional house meetings with the staff but no records were available for these at the time of the visit. People were positive about the food that is provided and explained how they are involved in cooking and planning. Some improvements were required in respect of this following the last inspection and not all the information was available at this visit. There appeared to be no menu for the week and people were unclear what they would be cooking over the next few days. There was fresh produce in the home and some packaged food but it appeared there was still room for increased service user involvement in the planning of menus and doing the shopping. The risk assessment in regard to one persons cooking tasks has been redone and they confirmed that they now have more opportunities to prepare meals. People explained how they are getting advice and support to follow a healthy eating plan. All three people using the service were very positive about the skills and confidence they have gained in order to live semi independently with occasional support from staff. As mentioned in the previous standards there is scope to further improve the structure, and reviewing, around the development of independence skills. Care Homes for Adults (18-65 years) Page 14 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples personal care and healthcare needs are met, promoting their dignity and wellbeing. Satisfactory arrangements are in place for the handling of medication, promoting service users wellbeing and encouraging their independence. Evidence: People all have Health Action plans in place and also records of health appointments that have been attended and actons that are needed. People explained how they attended these independently, or with staff support if they requested it. People often make their own appointments and one person was observed reordering their medication during this inspection visit. The care plans detail the personal care needs of people and people said they were very happy with the support that is provided by the staff. This is mainly in the form of advice and reminders. Care Homes for Adults (18-65 years) Page 15 of 25 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. The home provides a safe environment for service users in which they are respected and treated with dignity. Systems are in place to ensure service users are protected. Evidence: The senior care worker responsible for the home has undertaken training in adult protection. There are on call arrangements in the home in case of emergencies for when the home is unstaffed and people were able to describe how these worked and confirmed that when they had cause to use them the staff had responded quickly. People explained how they were able to raise concerns or issues, either with the Provider or with the two staff who worked in the home. People said that they always listened and responded to their concerns. People said they felt safe in the home. Care Homes for Adults (18-65 years) Page 16 of 25 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. Service users benefit from a home that is well maintained and decorated throughout and provides a comfortable homely environment. Service users are supported and encouraged to personalize their living space and are involved in all decisions relating to redecoration of the home. Evidence: The home was clean and hygienic throughout at the time of this inspection. The people living in the home take pride in their home and are involved in planning maintenance and decoration. People personalize their rooms and all have keys to the home. All said they were pleased with their accommodation and that it met their needs. People confirmed that there had been no more problems with electrical repairs to the domestic equipment, which had been an issue identified at the previous inspection. Care Homes for Adults (18-65 years) Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are supported by a staff team that relates well to them and has a positive approach to their care and support. The recruitment and selection framework helps to safeguard the people living in the home. Evidence: The service has now been organized to have more regular staffing input, with set hours being provided every week from two staff. The people living in the home felt they received sufficient staffing hours, and also said they were able to contact staff if there were any emergencies. People said that they had been able to do this when the need had arisen. People were positive about the care and support they get and said that the staff treated them with respect and were always helpful and caring. One person is provided with a male key worker from the other home run by the Provider, who he sees at the weekends, as both workers in the home are female. They said they were happy with this arrangement. The recruitment records for the newly employed staff were seen and these contained the required information and evidenced that all the required checks had been Care Homes for Adults (18-65 years) Page 18 of 25 Evidence: completed. Care Homes for Adults (18-65 years) Page 19 of 25 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. Some direction and leadership is provided within the home in the abscence of a registered manager but there is a need to provide formal supervision and scrutiny of the service to ensure people are fully protected and that individual outcomes are achieved. People using the service could benefit from the introduction of a more formal system of quality assurance. Evidence: The home currently does not have a registered manager in post and the home has shared its manager with another service run by the same Provider, who was interviewed as part of this inspection. The service is currently being run by a senior care worker and the deputy manager is acting as manager for the two services. However the deputy has no day to day involvement in the service as the senior care worker is reporting directly to the Provider. The senior carer has received informal support and guidance from the deputy manager but no formal supervision has taken place. The senior carer should be provided with formal supervision and guidance until Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: a manager has been appointed. Clarity must be provided by the Provider to the people using the service and to the staff exactly what the management responsibilities and arrangements are whilst the service is without a registered manager. The senior care taking responsibility for the service has implemented a number of changes around care planning and improved opportunities for the learning of independence skills. They have also provided the service with a more structured working week in terms of staffing hours. People using the service were positive about the changes being implemented and their relationship with the new senior carer. The fire safety records were not available at this visit but one of the people living in the home explained how the checks and tests have been completed. People said they have all received fire safety training but the records of this were not seen at this visit. People explained what they would do in the event of a fire. A safe environment is maintained within the home. The views of the people living in the home have been sought in regards to the running of the home but no formal quality assurance systems have been implemented over the past twelve months. Care Homes for Adults (18-65 years) Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R 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 Care Homes for Adults (18-65 years) Page 22 of 25 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 Requirement 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 Requirement Timescale for action 1 1 4 The service must review and 29/09/2009 update its Statement of Purpose Potential users of the service must be provided with accurate and up to date information 2 9 13 The service must ensure 29/08/2009 that all risk assessments are reviewed appropriately and up to date To ensure people using the service are properly protected any risks should be correctly managed and reviewed accordingly 3 37 8 The Provider must provide clarity with regards to the interim management arrangements to people using the service and to the Commission. In the absence of a registered manager people using the service and staff 29/07/2009 Care Homes for Adults (18-65 years) Page 23 of 25 must be aware of the interim management structure in place. 4 37 8 The senior carer managing the home must receive formal supervsion and support. In the abscene of a registered manager there must be systems in place to provide supervision and scrutiny of the service 5 37 8 The service must appoint and register a manager The home is required to have a registered manager 6 39 35 The home must introduce a more formal system of quality assurance The views of people using the service, staff and outside professionals should be consulted and involved in a formal quality assurance process. 29/10/2009 29/09/2009 29/07/2009 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 1 1 The service should provide its Statement of Purpose and Service User Guide in different formats Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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. 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