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Inspection on 14/11/05 for 12 Florence Street

Also see our care home review for 12 Florence Street for more information

This inspection was carried out on 14th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Admission of new service users is carefully considered and planned to ensure compatibility with others and to enable prospective service users to visit the home prior to admission. Service users are consulted about every aspect of their lives. Where restrictions on choice or liberty are imposed, due to the needs of service users, they are aware of the reasons. Service users are enabled to participate in community activities and work placements by the provision of risk management strategies and staff support. The use of public transport is encouraged and promoted. The organisation has a designated staff member to organise staff training to ensure that all staff have opportunities for training and participate in appropriate training programmes/courses, and these are paid for by the organisation.

What has improved since the last inspection?

A statement of terms and conditions has been devised and is awaiting final approval before being issued to service users. Redecoration and refurbishment is ongoing and a new fridge/freezer has been purchased. All staff are now up to date with fire safety training.

What the care home could do better:

No issues were identified at this inspection, although the Registered Manager needs to consider how to move forward with completing his qualifications.

CARE HOME ADULTS 18-65 Florence Street 12 Florence Street St Budeaux Plymouth Devon PL5 1QL Lead Inspector Antonia Reynolds Unannounced Inspection 14th November 2005 10:00 Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Florence Street Address 12 Florence Street St Budeaux Plymouth Devon PL5 1QL 01752 298425 NO FAX 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) Michael Batt Foundation (Valued Life Projects) Mr Brian Colin Roy Stokes Care Home 3 Category(ies) of Learning disability (3), Mental disorder, registration, with number excluding learning disability or dementia (3) of places Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Learning disabled adults some of whom may have a mental disorder Age 18-60yrs Date of last inspection 21st April 2005 Brief Description of the Service: 12 Florence Street is a care home providing personal care (if required) and accommodation for three people, aged 18 - 60, with learning disabilities, who may also have mental health issues. It is owned by the Michael Batt Foundation (Valued Life Projects) which is a not for profit organisation providing services for people with a range of needs who required support and care to live in the community. The home was opened in 2000 and is an end of terrace, two storey property, located in the residential area of St Budeaux in Plymouth. All the homes bedrooms are single and are on the 1st floor. None of these have en suite facilities. There is a bathroom and toilet on each floor. There are four lounge rooms, one of which is designated as a ‘no smoking’ room, and a kitchen diner. There is a garden at the rear of the property. All areas are accessible to the service users. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place between 10.00am and 12.45pm. The Registered Manager, Brian Stokes was present throughout and the Assistant Team Leader, Jason Bardell, was present for part of the visit. A tour of the premises took place and records relating to care and the home were inspected. The three service users, as well as one of the two staff members on duty, were spoken with and observed during the visit. What the service does well: What has improved since the last inspection? 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. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 6 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 Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 7 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): 1, 2, 3, 4 and 5 The home’s Statement of Purpose and Service User Guide provide service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: The home has a statement of purpose and Service User guide available in the home. All prospective service users are assessed prior to admission and as much information as possible is obtained from the service user, relatives and representatives, as well as other professionals involved in the person’s care. Discussion with service users confirmed that introductory visits were arranged for prospective and existing service users to meet each other and become familiar with the home prior to admission. Individual records are kept for each of the service users and these contained assessments, care plans, risk assessments and behavioural guidelines, all of which had been recently reviewed. Ongoing evaluation is recorded daily. Contracts with purchasing authorities are kept in the organisation’s head office and the organisation is in the process of devising statements of terms and conditions for the service users. General information is provided in the booklet “Information for people” provided by the Michael Batt Foundation. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 8 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 and 10 The service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user had a care plan, risk assessments and behavioural guidelines and the staff were fully aware of the needs of each person. Any restrictions on choice or freedom were documented and had been agreed with the service user and other people involved in the person’s care. Service users were able to describe and explain why these agreements were in place. The attitude and approach of the staff team promoted independence and empowered service users to make decisions about lifestyles and daily routines, demonstrating excellent practice. Discussion with the staff team, as well as observation, showed that confidentiality was understood and respected. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 9 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, 14, 15, 16 and 17 Service users can learn life skills, attend work placements, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Information in care plans, as well as talking with service users, showed that they were enabled to live as full a life as they wished to and had opportunities for personal development. Service users were encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. Service users were encouraged and enabled to find and keep paid employment. The home did not provide transport as service users are encouraged to use public transport wherever possible. However, occasionally staff cars are used, for which service users are expected to make a contribution towards the cost of petrol. It was evident, through observation during the inspection, that service users felt very ‘at home’ and were empowered to make decisions. Service users confirmed that they could make their own meals, drinks and snacks and chose the menu. There were locks on a kitchen cupboard and the refrigerator due to the needs of one of the service users who was aware of this and in agreement with it. The other service users Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 10 had their own keys to these locks and the person concerned was observed asking for the key and being given it by staff. Contact with relatives and friends was encouraged and there were no limitations in place regarding visitors to the home. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Service users receive support in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provided information about personal, emotional and health care needs. Service users and the Registered Manager confirmed that external professional advice and guidance was sought when necessary from local health care professionals or social services. Through observation it was clear that timings were flexible and the choice of the service user. A monitored dosage system for medication was being used and none of the service users were self administering. Medication was locked away safely and records pertaining to its administration were kept. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 12 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 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that the Registered Provider always deals with complaints seriously and any concerns from service users are listened to and acted upon immediately EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. The home has a complaints procedure and the service users explained how they would make a complaint and who they would talk to. Regular house meetings were held where any issues could be raised and dealt with immediately, although it was also clear from discussion that service users could raise any issue at any time. The management and staff team were aware of adult protection issues, procedures were available, and training has been undertaken, or is planned, for all staff members. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 13 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 and 30 The standard of the environment is satisfactory, providing service users with a comfortable and homely place to live. EVIDENCE: Redecoration and refurbishment is ongoing and the general environment has improved significantly over the last year. The home was comfortable, safe and clean. Each service user had a single bedroom on the 1st floor, none of which had en suite facilities or wash hand basins. Service users confirmed they did not need wash hand basins in their bedrooms. The Registered Manager has previously confirmed that wash hand basins would be fitted in service users’ bedrooms if requested. Bedrooms were individually furnished and contained many personal possessions. Bedroom doors did not have appropriate locks but service users confirmed this was not an issue. The Registered Manager confirmed that locks would be fitted if requested and subject to a risk assessment. Service users confirmed that they had chosen the décor and furnishings for their bedrooms. The home had a bathroom on each floor consisting of a combined bath/shower and a toilet. There were small bolts on the doors to afford sufficient privacy and the Registered Manager confirmed that these could easily be forced if staff needed to gain access in an emergency. However, the Registered Provider Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 14 should consider more appropriate locks as part of the overall improvement programme. There were shared rooms on the ground floor consisting of a kitchen/diner and a lounge room. In addition, each service user had their own lounge rooms that were individually furnished and decorated and contained many personal possessions, including pets such as birds. Infection control practices were satisfactory and items of personal protective equipment, such as disposable gloves, were available. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 15 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, 35 and 36 Recruitment procedures are robust, service users’ needs are met by high staffing levels and service users benefit from well supported and supervised staff. EVIDENCE: Discussion with staff, as well as observation, confirmed that they were clear about their roles and responsibilities. Discussions with a newly appointed staff member and the Registered Manager, confirmed that two references were obtained prior to commencement of employment and a Criminal Records Check had been applied for. Regular staff meetings and individual supervision sessions took place and were documented. The Registered Manager confirmed that there were usually three staff on duty during the day and evening with two staff members at night, one sleeping and one awake. Sleeping accommodation for staff was in the office on the 1st floor. The Registered Manager confirmed that he is usually on duty in addition to the staff members, from 9am to 5pm on approximately four days of the week (he also manages another small home), although these timings are flexible depending on the needs of the service users. The organisation operates an ‘on call’ system whereby members of the management team are available both in and out of office hours. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 16 The organisation has a designated staff member to coordinate and arrange training to maintain an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. The new staff member on duty confirmed that induction took place and that all staff members were expected to attend training on a variety of topics. The organisation does not tend to enrol staff on National Vocational Qualifications but have devised their own training, in consultation with the local College of Further Education, as this reflects the needs of the service users they support Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 17 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 and 42 The management approach is open, inclusive and positive, providing clear leadership and guidance. Empowerment and enablement of service users is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has been in post for approximately a year and is undertaking a level 4 National Vocational Qualification. On completion of this, he intends to undertake the Registered Manager’s Award. The members of management and staff who were spoken with confirmed that they are consulted and included in any decisions regarding the running of the home and that the management approach was very positive and inclusive. Monthly provider visits were being carried out and copies of the reports sent to the Commission for Social Care Inspection. Records relating to health and safety issues, such as risk assessments and the fire log book were available and up to date. The Registered Manager confirmed that all staff had attended training in fire safety awareness and emergency first aid. Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Florence Street Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 X DS0000003429.V263431.R01.S.doc Version 5.0 Page 19 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. Standard Regulation Requirement Timescale for action 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 Florence Street DS0000003429.V263431.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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