Inspection on 04/05/06 for 12 High Street

This inspection was carried out on 4th May 2006.

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.

Other inspections for this house

12 High Street 08/02/06

12 High Street 26/07/05

12 High Street 21/02/05

12 High Street 21/02/05

12 High Street 21/02/05

12 High Street 21/02/05

12 High Street 12/11/04

12 High Street 12/11/04

12 High Street 12/11/04

12 High Street 12/11/04

12 High Street 14/01/04

12 High Street 14/01/04

12 High Street 14/01/04

12 High Street 14/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 12 High Street Brant Broughton Lincolnshire LN5 0SL Lead Inspector Wendy Taylor Key Unannounced Inspection 4th May 2006 10:05 12 High Street DS0000040002.V290056.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 12 High Street DS0000040002.V290056.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. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 12 High Street Address Brant Broughton Lincolnshire LN5 0SL 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) 01400 272929 01400 273438 Cambian Care Services Limited Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. A maximum of 5 young adults aged between 16 and 25 years of age, on admission, may be accommodated. Two named Service users, who are both over the age of 25 years, may remain at the home pending plans to identify appropriate move on placements. Young Adults, who have aged beyond 25 years of age, due to placing authorities not having identified and obtained appropriate move on placements, may only be accommodated at the home on an Application for Variation. The provision of care is for medium to long-term placements. Admissions are planned and emergency admissions are not accepted. 4. 5. Date of last inspection 8th February 2006 Brief Description of the Service: 12 The High Street is a 5 bedded home and was registered for younger adults with a learning disability in March 2003. The home is operated by Cambian Care Services and is situated across the road from Broughton College, a larger residential establishment, owned by the same company, for the same service user group. The home is located in Brant Broughton, where local shops are within walking distance. Access to public transport is available and the home has its own vehicle in order to access resources in the wider community. The home is a two storey domestic style residence and in keeping with the local community. All bedrooms are for single occupancy and, with the lounge, dining and kitchen areas; this home provides a homely and comfortable environment for the service users. Attached to the rear of the building is a self-contained annexe with lounge/kitchen, bedroom and bathroom to promote independent living. The home is situated within landscaped gardens. The aim of the home is to provide a safe and supportive environment and to promote the emotional, social and independence skills of the service users. The staff promote a clear perspective on respect for the rights of individuals to privacy and dignity and to work in partnership with families and other agencies. The current fees for the service are £4500:00 per week. The email address is graham.owen@cambiangroup.com 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over approximately 5 hours. The support received and the experience of two service users was looked at in detail during the visit, together with care records, staff records and general home management records. Service users, staff and the acting manager were spoken to and observations of the care practices were made. What the service does well: What has improved since the last inspection? What they could do better: The home maintains high standards of care and support and provides a good service to the people who live there. No requirements were made at this inspection, however a recommendation was made to consider the provision of alternative leisure space within the home for those who do not wish to sit in the lounge or their bedrooms. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 6 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. 12 High Street DS0000040002.V290056.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 12 High Street DS0000040002.V290056.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users benefit from a thorough assessment process that clearly identifies needs and strengths. EVIDENCE: Two service user files were looked at. Although the service users had lived at the home for a number of years assessments were available on each file. They included health needs, medical history, personal information, educational needs and the person’s strengths. There was evidence that service users, relatives and relevent professionals are involved in the process of the assessment and that the assessment is reviewed and updated at least every six months. 12 High Street DS0000040002.V290056.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 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from detailed care plans that reflect assessed needs, and they are consulted about their daily lives. EVIDENCE: There are care plans in place in each file for needs such as behaviour, continence and choices. Risk assessments are also in place for needs such as vulnerability, restriction of liberty, behaviour and self harm. Choice and decision making is clearly referred to in care plans, and there are instances of specific care plans to develop a persons ability to make a choice. There are recording sheets to demonstrate that care files are audited on a monthly basis and care plans and risk assessments are cross referenced. Service users knew about their files and one person guided the inspector through theirs. A service user was clear who their key worker is. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 10 Daily notes are very clearly written and staff were observed to respond positively to the choices and decisions made by service users. Staff were also observed to present choices in a manner that service users could understand, for example reducing the complexity of sentences and having picture cards and objects of reference available. 12 High Street DS0000040002.V290056.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 - 17 Quality in this outcome area is excellent. This judgement has been made using the available evidence including a visit to the service. Service users are able to develop their independence and maintain control of their daily lifestyles. They also benefit from the opportunity to engage in an extensive range of leisure and personal development activities. EVIDENCE: Each service user has a ‘life file’ in place showing contact with family and friends and their preferred activities in the form of photographs, letters and comment sheets. There is evidence of individual activity programmes which are split into leisure, education and home management activity. During the visit service users were observed to engage in activities such as horse riding, paper rounds, cooking and going for walks. All of the activity seen at the visit were in accordance with the individual programmes. There was also 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 12 evidence of activities such as going to visit families, cleaning, swimming, bowling and use of the gym. Education staff continue to support service users and home staff with daily activity and the acting manager said that holidays are now planned for this year. Individual learning plan reviews show the progress that service users make with development of their independence and staff were seen to encourage social interaction between the people living in the house. Service user’s right to choose not to join in with any task or activity was respected by staff and alternatives were offered. Menus were available that were in accordance with a shopping list that was being developed. Service users said they enjoyed their food and they help to shop for the food. One person was preparing lunch with help from staff and there is now an agreement for staff to eat with service users but no budget has yet been identified. Staff were observed to maintain privacy and dignity for people by knocking on bedroom doors and discussing needs in private. Bedroom doors have locks to prevent anyone going in uninvited but allowing the service user to exit without the need to unlock the door. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 13 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users health and personal needs are met and they are protected by a robust medicines policy and procedures. EVIDENCE: There is a health needs file for each service user which contains information and records in relation to needs such as epilepsy, dental, GP, chiropody, psychology and psychiatry. There are separate recording sheets for each specific health intervention that enables easier tracking of appointments and changes to need. Care plans also reflect emotional needs such as withdrawal from company and anxiety. Recording and administration of medications was satisfactory as was the policy which is available on the company’s intranet site. There are clear protocols in the medication files for the administration of ‘when necessary’ medication. There was also evidence in files that medication records are audited every 12 weeks in line with the time span of the new medication record sheets. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 14 The home now has a fridge for storing medications that need to be kept below room temperature, and temperature of the fridge has been recorded regularly. There are recording sheets in place for medication that is taken out of the house by the service user when they attend activities and a recent pharmacy inspection report did not raise any issues. 12 High Street DS0000040002.V290056.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 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home has robust and accessible policies and procedures, and a welltrained and knowledgeable staff team. EVIDENCE: There have been no complaints, child or adult protection issues raised since the last inspection. Adult and child protection, and the complaints policy were available on the company intranet site and staff demonstrated that they were aware of their location. Staff confirmed that they have received training in adult and child protection, and they demonstrated that they knew what to do in the event of a complaint or protection issue being raised. Care plans for self harm are in place and reviews show a reduction in the incidence of this occuring, due to the management techniques used by staff. Staff were seen to listen to what service users had to say and they responded positively to their views (see also Standards 6-10). 12 High Street DS0000040002.V290056.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): 24,25,26,28,30 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. Service users benefit from having comfortable and personalised bedrooms, within a well maintained and hygienic home. They would benefit further from the addition of extra indoor activity space. EVIDENCE: During a tour of the house the environment was found to be clean and tidy, and the furniture and décor was well maintained. Service users were helping to maintain the clean and tidy environment as part of their home management skill development. The garden areas were also well maintained and service users said that they were helping to grow vegetables in the greenhouse. Substances used for cleaning were securely stored in the laundry area and the home benefits from a separate sluice facility. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 17 Shared spaces such as the lounge are comfortable but given the diverse needs of the people living in the house there is no extra space available for service users to go to if they dont want to watch TV or sit in their bedroom. A recommendation has been made in regard to additional indoor leisure space. Bedrooms are nicely personalised with posters and photographs and all have en-suite bathrooms. A service user said that they like their room (see also St 11-16 regarding bedrooms). 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 18 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 – 36 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. There is a well-trained and supported staff team who are able to meet service user’s needs. EVIDENCE: Three staff files were looked at and recruitment records required by the Care Homes Regulations 2001 were in place including Criminal Record Bureau checks and employment references. Staff said that they have received training in Developing A Positive Approach (behavioural needs), communication, fire safety, autism, induction,service user specific needs and there is evidence that they are undertaking National Vocational Qualifications (NVQ) at level 3. During discussions and observations of practice they demonstrated a clear and detailed knowledge of service user need. There was evidence of regular supervsion both from discussions with staff and the records kept in the home. Staff said that job descriptions are used to generate discussions at supervision sessions and they find the sessions useful for their development. They said that they receive good support from their team leader who is open and helpful. There was evidence of monthly staff meetings, and staff said that there are good shift handover periods. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 19 They said that they like the current team framework as it provides for good communication between staff, consistency for service users and a clear management structure. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 20 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using the available evidence including a visit to the service. The home is well managed and organised, with quality assurance systems that promote continued development. EVIDENCE: The acting manager is an experienced nurse and has almost completed the Registered Managers Award (NVQ Level 4). He said that he will be applying to the Commission for Social Care Inspection in near future for registration as the manager. Discussion took place regarding allocated management hours within the home. The fire safety records were seen to be up to date and there was record of a recent fire evacuation drill noted in a service users daily notes. The service user was able to demonstrate their understanding of fire safety issues. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 21 The acting manager said that there are plans in place and funds available in this years budget to convert the garage into office space so as to improve the current arrangements. There was evidence that regular monthly management visits under Regulation 26 of the Care Homes Regulations 2001 are carried out and the reports are available at the central office site. There is also evidence of daily management monitoring of accidents/incidents by acting manager. Regular audits of care files and medicine files were seen and the acting manager said that there has been a recent staff survey regarding stress at work. The acting manager also said that the service has had their Investors In People Award renewed in February 2006. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 22 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 3 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 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 4 12 4 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? No 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. 1. 2. Refer to Standard YA17 YA28 Good Practice Recommendations It is recommended that the home should continue to develop practice around mealtimes. It is recommended that the home reassess the need for additional indoor leisure activity space. 12 High Street DS0000040002.V290056.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 12 High Street DS0000040002.V290056.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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