Inspection on 21/04/05 for 12 Florence Street

This inspection was carried out on 21st April 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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.

Other inspections for this house

12 Florence Street 07/02/07

12 Florence Street 14/11/05

12 Florence Street 02/11/04

12 Florence Street 02/11/04

12 Florence Street 02/11/04

12 Florence Street 02/11/04

12 Florence Street 07/07/04

12 Florence Street 07/07/04

12 Florence Street 07/07/04

12 Florence Street 07/07/04

12 Florence Street 01/03/04

12 Florence Street 01/03/04

12 Florence Street 01/03/04

12 Florence Street 01/03/04

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The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

Honeybourne House

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

CARE HOME ADULTS 18-65 Florence Street 12 Florence Street St Budeaux Plymouth PL5 1QL Lead Inspector Antonia Reynolds Announced 21/04/05 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 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 Stationary 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 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Florence Street Address 12 Florence Street, St Budeaux, Plymouth, Devon, PL5 1QL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01752 298425 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 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Learning disabled adults some of whom may have a mental disorder Age 18-60yrs Date of last inspection 2nd November 2004 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 a designated 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 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 9.30am and 4.15pm. The Registered Manager, Brian Stokes was present, along with the Team Leader, Robin Vacquier (morning only) and the Assistant Team Leader, Jason Bardell. A tour of the premises took place and records relating to care, the staff and the home were inspected. The two service users (the home had one vacancy), as well as staff on duty, were spoken with and observed during the day. What the service does well: What has improved since the last inspection? What they could do better: The Registered Provider has not yet provided a statement of terms and conditions of residency for service users, and this was discussed during the inspection. Recruitment procedures must be followed to ensure that two written references are obtained for all new staff members prior to employment. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 6 Fire safety training for staff needs to be carried out more frequently. The Registered Provider has been asked to consider advice given during the inspection regarding the provision of wash hand basins and door locks for bedrooms, more suitable locks for bathrooms, undertaking risk assessments for safe working practice topics and minor amendments to various pieces of documentation. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 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 Standards Statutory Requirements Identified During the Inspection Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 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 standard(s) 1, 2, 3, 4 and 5 Service users and prospective service users are not provided with adequate information as they do not have a statement of terms and conditions. Prospective service users are given opportunities to visit the home to decide whether they would like to live there and to meet the other service users and staff. EVIDENCE: The statement of purpose and Service User guide were available in the home. All prospective service users are assessed prior to admission and a detailed assessment tool has been devised. 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 and this is documented. Introductory visits are 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, but statements of terms and conditions of residency have not been produced for each service user. General information is provided in the booklet “Information for people” provided by the Michael Batt Foundation. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 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 standard(s) 6, 7, 8 and 9 The service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user has a care plan, risk assessments and behavioural guidelines that are regularly reviewed. The staff were fully aware of the needs of each resident. 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 promotes independence and empowers service users to make decisions about lifestyles and daily routines, demonstrating excellent practice. Records relating to service users’ money were up to date and accurate. From these it was evident that service users were expected to pay for personal items, as well as making a contribution towards the cost of transport. The organisation provides additional money for clothing and leisure activities. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 10 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 standard(s) 11, 12, 13, 14, 15 and 16 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. The rights of service users to be politically active was demonstrated through a lively discussion about the forthcoming general election and service users were aware of their rights to vote. Service users were also 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. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 11 Contact with relatives and friends was encouraged and there were no limitations in place regarding visitors to the home. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 12 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 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 was being used, regulation medication reviews took place and risk assessments had been carried out regarding whether or not service users were able to keep their own medication, the result being that no-one selfadministered medication. Medication was locked away safely and records pertaining to its administration were up to date and accurate. A discussion took place about expanding the organisation’s medicines policy to include the ethos of the home. Advice was given to refer to the Royal Pharmaceutical Society’s guidance on the administration of medicines in care homes. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 13 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 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. Each service user received the personal allowance element of income support each week, from the organisation’s head office, to spend as they wished. The mobility component of Disability Living Allowance was kept in the home and used for transport costs as required by the service users. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 14 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 standard(s) 24, 25, 26, 27, 28 and 30 The home has recently been refurbished and redecorated in places, which is a significant improvement. It is comfortable, safe and clean. Bathroom and toilet facilities were adequate for the present service users. Service users are ‘at home’ in the environment and clearly feel they belong. EVIDENCE: Each service user has a single bedroom on the 1st floor, none of which had en suite facilities or wash hand basins. During one conversation, service users confirmed they did not want wash hand basins in their bedrooms, however during a later conversation, one of the service users said he did want a wash hand basin, and was very clear about the reasons for this. Bedrooms were individually furnished and contained many personal possessions. Bedroom doors did not have appropriate locks and one of the service users said he would like a lock, and was clear about the reasons for this. The management team agreed that they would discuss the request for a wash hand basin and lock with the particular service user and confirmed that this would be provided if required and subject to a risk assessment. Service users confirmed that they had chosen the décor and furnishings for their bedrooms. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 15 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 should consider more appropriate locks as part of the overall improvement programme. The Registered Manager confirmed that wash hand basins would be fitted in service users’ bedrooms if requested. There were shared rooms on the ground floor consisting of a kitchen/diner, a lounge room and a smoking 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 fish and birds. Infection control practices were satisfactory and items of personal protective equipment, such as disposable gloves, were available. Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Recruitment procedures are not being followed which may place service users at risk. Service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff. EVIDENCE: Staff files inspected showed that the organisation has not adhered to its recruitment procedure on every occasion as two of the four staff files inspected did not contain two written references. Criminal Record Bureau checks had been carried out but were kept in the organisation’s head office. All staff were provided with contracts of employment and job descriptions. Regular staff meetings and individual supervision sessions took place and were documented. 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. Staff confirmed that they were expected to attend relevant training on topics such as social role valorisation, person centred planning and human development. 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 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 17 Staffing rotas were available in the home showing that there were always two staff on duty who slept in the home during the night. Sleeping accommodation for staff was in the office and the spare bedroom. The Registered Manager confirmed that he is usually on duty in addition to the two staff members, from 9am to 5pm Mondays to Fridays, 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 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 18 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41 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 five months 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. All documentation relating to service users was up to date and accurate. Records relating to health and safety issues, such as risk assessments, the accident book, fire log book, employers liability insurance certificate and gas safety checks were available and up to date. Fire safety training for staff had not been carried out as frequently as required, although no immediate risk was Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 19 identified due to the layout of the home and the numbers of service users. All staff complete training in emergency first aid. The use of hot water has been risk assessed and none of the hot water is regulated as this is not deemed necessary for the service users. A discussion took place about the benefits of documenting risk assessments relating to safe working practice topics, which may identify staff training needs, such as health and safety and moving and handling. Records were kept of the temperature of the refrigerators/freezers but there was no hot food probe available. Advice was given to risk assess and provide one if necessary. Documentation was available confirming that health and safety checks, including checking portable electrical appliances, had been carried out by the person responsible for the monthly provider visits. The organisation has devised a quality assurance system which will be implemented in due course. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 Florence Street Score 3 3 3 Standard No 22 23 Score 3 3 Version 1.20 Page 20 D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc 4 5 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 N/A 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 2 x Florence Street D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 21 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 5 Regulation 5 Requirement A standard form of contract or statement of terms and conditions must be included in the Service Users Guide. (Timescale extended further. This requirement has been outstanding since January 2004). Two written references must be obtained before new staff members commence employment. All staff members must receive training in fire safety awareness every six months. New staff must receive two sessions of training in the first month of employment. Timescale for action 21 October 2005 2. 34 19 21 July 2005 21 July 2005 3. 42 23 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 42 Good Practice Recommendations Staff on night duties (including those sleeping in) should receive training in fire safety awareness every three months. D52-D04 S3429 12 Florence St V210942 210405 Stage 4.doc Version 1.20 Page 22 Florence Street Commission for Social Care Inspection 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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