Inspection on 25/02/06 for 119 Victoria Street

This inspection was carried out on 25th February 2006.

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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

119 Victoria Street 17/06/09

119 Victoria Street 19/06/08

119 Victoria Street 22/06/07

119 Victoria Street 13/06/06

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 08/07/2008.

CARE HOME ADULTS 18-65 119 Victoria Street 119 Victoria Street Cinderford Glos GL14 2HU Lead Inspector Mr Simon Massey Unannounced Inspection 25th February 2006 11.30a 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 119 Victoria Street Address 119 Victoria Street Cinderford Glos GL14 2HU 01594 516582 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) Mr Thomas Alfred Mills Mrs Beverley Mills Mr Graham Fredrick Jeremiah Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: 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. Two part-time staff work in the home. 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. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 2 hours on Saturday 25th February 2006. Two of the three service users who live at the home supported the inspection. No staff were on duty at the time of this visit but the Registered Provider was contacted by the service users, and they then called in briefly to meet the inspector. Another staff member who lives close to the home also called in to provide some additional input and support. Records were examined relating to care planning and health and safety and a brief inspection of the environment was also carried out. The inspectors met and interviewed the two service users and also spoke with the member of staff who called in to the home. The inspector wishes to thank the two service users for their help in conducting this inspection. What the service does well: What has improved since the last inspection? No areas were identified as having improved since the previous inspection. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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: Not inspected. There have been no admissions to the home during the previous two years. The current service users moved to the home from the other registered property run by the same Provider. The move provides greater opportunity for independence and the development of the required skills. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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): 6,7,8 & 9 Lack of an effective care planning system means that goals and objectives are not clearly identified. The lack of a structured approach to developing and maintaining skills means service users are not making the most of the opportunity to live a more independent lifestyle. EVIDENCE: None of the care plans were available at the home at the time of the inspection. The service users explained that two of them had had reviews the previous week and another was booked for the coming week. All the paperwork was apparently with the registered manager. Neither service user had had any formal involvement in the preparation for these reviews but one stated they had attended the review meeting that took place the previous week. This had been attended by the placing authority’s social worker. The other service user stated they would be attending their meeting in the coming week. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 10 Neither service user could recall any goals or objectives relating to their future that they had identified or had been suggested to them. They considered the review was intended to establish whether they were happy were they living, or whether they wished to move. Both people were also unclear about the content of their care plans and seemed to consider this a matter for the manager. Considering the home aims to provide greater independence, choice and the opportunity to develop the required skills to achieve this, this is poor practice. The inspector could find no other documentation, or paperwork relating to the training or support that is provided to promote the necessary skills required to achieve greater independence and choice. The home is un-staffed for considerable periods of time but no risk assessments could be found in relation to this. Further reference to this is made in the staffing and management standards. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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): 11, 12, 13,15 & 17 Opportunities for personal development and independent living would be better supported with more structured care plans. Increased staff support is required to support greater access to the local community. Service users enjoy the opportunity to live more independently and take responsibility for their daily lives. The menu planning, budgeting, shopping and cooking arrangements need to be reviewed to ensure that sufficient food is available at all times and that service users are as involved in these processes as far as their abilities allow. EVIDENCE: Two of the three service users were at home at the time of this visit and it was explained that the other person had travelled independently to visit a friend in another town close by. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 12 Later that day they were due to be taken to the sister home for the rest of the afternoon. Neither had any other plans for the weekend and said they were happy to stay in the home and relax. No staffing is provided in the home over the weekend but support is available if required from a staff member who lives near by, and also from the other home, which is contactable by phone. Until recently all three service users did unpaid work at a local sports gym five days a week, which constituted the bulk of their daytime activities. Other time is spent at the other home and two people also attend college once a week. However it was explained that due to some difficulties, the work has been stopped but possibly may start again after Easter. No alternative has been found in the meantime apart visiting the activity room/centre at the other home. The inspector was concerned at the lack of variety in day care provision, with all three people undertaking the same activity together. The care plans, which were seen at a later date, did not identify any clear goals or objectives in terms of daytime occupation or activities. As with the other comments relating to the care planning, the home needs to develop these opportunities based upon the individual assessed needs and wishes of the service users. It was also evident that living together and also working together was placing some strain upon the relations within the home. The house diary, and conversation with the service users, showed that relatively few evening activities are supported by staff, with the majority of opportunities involving visiting the other home. Staffing has been previously provided on a few evenings a week, but this is not provided at present. The inspector was concerned about one service user who said that they never went out in the evening on their own, due to a lack of confidence. The staff member explained the wider issues to this, but there should be a plan in place to address or support this area, particularly as the home is promoting independence. There was very little food in the house, the fridge continued cheese, corned beef, marmite and milk. There was also half a loaf of bread, some cereals and a half a packet of biscuits. The larder cupboard contained a tin of carrots, spaghetti and sweetcorn. There were no fresh vegetables, fruit, savoury snacks or other fresh produce. In the freezer there was a packet of sausages and three ready meals. The menus show that the food provided for lunch and breakfast is limited in variety and the evening meals recorded show a high portion of processed and frozen food. The service users also appear to eat a regular number of evening meals, between three and four, every week at the sister home. The majority of food is purchased and delivered by the registered provider, with the service users having little involvement. They can buy items out of 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 13 their personal money at the weekend and get this reimbursed, but this would generally be milk or small items. Service users have no structured plans or support to teach them menu planning, budgeting and shopping. Considering the low staffing levels and the aims of the home this is poor practice. There is also no information in the home about the ranges of meals or skills that they are competent to cook unsupervised. Both service users have acquired cooking skills through college courses that have resulted in them achieving qualifications, but this progress has not been built upon by the home. Better care plans providing structured guidance on the development of skills should provide the service users with the opportunity to take more responsibility for menu planning, budgeting, shopping and cooking. Both service users said they enjoyed living at the home and preferred the greater independence that it offered them. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Not inspected during this visit. EVIDENCE: 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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): 22 & 23 Service users are aware of safety issues and take responsibility for the security of their home. Service users are able to approach care staff or the Registered Providers to raise concerns or make a complaint. EVIDENCE: The service users supported part of this inspection without staff support and demonstrated an awareness of their personal safety by checking the inspectors ID and also telephoning the Provider to inform them of the inspection. Service users also have their own mobile phones which helps to protect their safety when out independently in the community. Service users were positive about their relationships with the staff and the Providers. Both stated that they could raise problems and issues, or make a complaint, and that they were listened to. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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): 24,25,26,27,28&30 Individual rooms are personalised according to personal taste and preferences. Service users are satisfied with their accommodation. Service users take responsibility for maintaining a clean and hygienic home. EVIDENCE: The entire environment was inspected and the home was seen to be well maintained and decorated throughout. The housework is done entirely by the service users and to a high standard. All parts of the environment were clean and hygienic and the home appeared to be reasonably decorated throughout. Service users confirmed that they had chosen the décor of their rooms. All the bedrooms were personalised and reflected the tastes and interests of the occupants. Both people present expressed satisfaction with their accommodation. The home and individual rooms are personalised and reflect the interests of the service users. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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): 31, 32, 33 & 34 The effectiveness of the staff would be improved by the provision of more guidance around the development of independence skills. Service user’s needs would be better met with more flexible staffing cover in the evenings and weekends. Service users are protected by the homes recruitment policies and procedures. EVIDENCE: The staffing arrangements were explained by the service users, and also by a staff member who lives nearby who called in for part of the inspection. Support is regularly provided every weekday morning by this one staff member. The manager also calls in once or twice a week as well. The two homes run by the Providers share the same staff team and the same manager. Within the home there were no written rotas, staffing information or written guidance for staff. There was limited recording of activities incidents or issues. No regular staffing input is provided at the weekends or evenings and a certain part of every weekend is spent at the sister home. Service users were very positive about the support and care they receive from the staff and said they could talk issues through and get advice when they 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 18 needed it. They thought the staff were “nice people” and were “always helpful”. The inspector was concerned that the staffing provided did not have the structure required to support the development and use of independence skills. Further evidence of this is contained in the Lifestyle Standards 11 to 17. It was also evident that some of the emotional needs of the service users required input from staff but no guidance was in place. The care plans, which were seen at a later date, provided little information for staff to base their practice upon. The inspector was informed that a staff member had recently been allocated a responsibility for “overseeing” the home but it was unclear what this responsibility entailed and how this fitted in with the responsibilities of the registered manager. The staffing records are all kept at the sister home and these were checked at a later date and all the required information was in place. The Commission accepts this arrangement but the home must contain a basic staffing list containing the names and contact numbers of any staff who work in the home. The staffing arrangements in the home should be linked to the needs of the service users and be flexible enough to provide additional input when required at the appropriate times. A basic rota should be in place that provides some guidance as to the amount of cover and support the home receives. At present the staff sign in when they work, which provides a record of the hours completed, but it is unclear how service users could access additional support if required. The home appears to be monitored rather than managed and this needs to be addressed if the service users are to develop and build upon the independence they have achieved so far. The staff member spoken to during this inspection demonstrated a good professional understanding of the needs of the service users and it was evident had an appropriate and positive relationships with all three people. The staff files were examined during the inspection the following week at the other home run by the Provider. These files contained all the required documentation and information. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 19 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, 38 & 42 A lack of leadership and direction is undermining the ability of the service users to further develop confidence and practice their skills in independent living. Service users are potentially at risk due to safety checks not being completed within the required timescales. EVIDENCE: The issues identified around care planning, staffing cover and food raise concerns about how the home is being managed and monitored. As stated earlier in the report a new staff member has been given responsibility by the manager for “overseeing” the home. It was unclear what this responsibility entailed. There appears to be a lack of direction and leadership in the move towards enabling the service users to live a more independent lifestyle. All fire testing and recording had been completed and equipment had been serviced and checked. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 20 The central heating system had not been tested since 13/11/04 and also the PAT testing had not been done since 15/05/04. Requirements have been made in respect of this. 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 21 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 X 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 3 26 3 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 X 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 2 2 x LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 x 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 2 2 X X X 2 x 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 22 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15 Requirement Timescale for action 30/05/06 2 YA9 3 4 YA33 YA13 5 YA38 5 YA12 6 YA17 The home must improve the care planning system to ensure that it is person centred and that service users are fully involved in the developing and reviewing of their care plans. 12(1)(a) The home must produce risk assessments relating to the degree of supervision and independence provided in the home. 18(1)(a) The home must produce a written record of the minimum staffing cover that is provided 18(1)(a) The home must provide staffing when needed to support and develop access to the local community in the evening and weekends 12(1)(a)(b) The home must provide clarity over the responsibilities of the staff member who has a designated responsibility for the home. 12(1)(b) The home must support service users to access day care activities that are based on their individual assessed needs and aspirations 16(2)(h)&(i) The home must review the DS0000016319.V284804.R01.S.doc 30/05/06 30/05/06 30/05/06 30/05/06 30/05/06 30/05/06 Page 23 119 Victoria Street Version 5.1 7 YA42 13(4)(a) menu planning, budgeting and cooking arrangements to ensure that sufficient food is available at all times and that service users are fully involved in this The home must complete a safety check on the central heating system and also have the PAT testing completed. 30/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 119 Victoria Street DS0000016319.V284804.R01.S.doc Version 5.1 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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