Inspection on 31/05/05 for 120 Feckenham Road

This inspection was carried out on 31st May 2005.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

120 Feckenham Road 21/08/06

120 Feckenham Road 30/12/05

120 Feckenham Road 17/02/05

120 Feckenham Road 08/06/04

120 Feckenham Road 23/03/04

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

CARE HOME ADULTS 18-65 120 Feckenham Road 120 Feckenham Road Headless Cross Redditch, Worcestershire B97 5AG Lead Inspector Martha Nethaway Unannounced 31 May 2005 15:00 st 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. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 120 Feckenham Road Address 120 Feckenham Road, Headless Cross, Redditch, Worcestershire B97 5AG 01527 544064 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) Royal Mencap Society Care Home 5 Category(ies) of LD Learning Disability (5) registration, with number Physical disability (3) of places 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: In addition to those referred to on the previous page, the following condition applies: The service is primarily for people with a learning disability but may also accommodate people with an additional physical disability. Date of last inspection 17 February 2005 Brief Description of the Service: The care home at 120 Feckenham Road provides long term care for a maximum of five adults with learning disabilities. The conditions of registration also permit up to three service users with additional physical disabilities, dementia and/or visual impairment to be accommodated. Two people with mobility problems can be accommodated in ground floor bedrooms. The aim of the home is to support service users to lead as normal a life as possible with active involvement in the local community.The home was formerly a large family house that has been adapted for its present purpose. It was located in a pleasant residential area of Redditch and has a level, enclosed garden at the rear. Service users are accommodated in single bedrooms, two of which have an en suite bathroom or shower room.The premises are owned by Golden Lane Housing Association and the registered proprietor is the Royal Mencap Society. The responsible individual is Ms Janine Tregelles. The service manager is Mr T. Hickey who provides line management support and supervision to the registered manager. Prior to the inspection, there had been a number of staff changes including a series of acting managers. The present acting manager had been in post seven months and was applying for registration. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and commenced at 3:00pm. It took place over 3 hrs and the inspector visited the home to observe the afternoon routine. One of the service user’s files was examined and other records were sampled. The acting manager was interviewed. The deputy manager and two staff were also spoken to. One of the service users gave a guided tour of the home and discussed their experiences of living at the home. The remaining service users were less well able to talk due to shyness or limited verbal communication. Therefore, observation and discussions was a key feature of this inspection with the care staff on duty. The inspector would like to thank the staff team and service users for their time and cooperation. 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. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 standard(s) 2 Proper arrangements existed for all new admissions to the home including an appropriate assessment procedure. EVIDENCE: All prospective service users receive an application pack, containing detailed information about the home. The home was in the process of admitting a prospective service user. The records sampled demonstrated a full assessment format and the overall gathering of information was good. Four introductory visits had been arranged. The manager had organised a further post placement meeting to ensure that a proper planned transition to the home was arranged. This ensured that the suitability of the placement was considered. Any preparatory work needed prior to the service user moving into the home would also be addressed. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 standard(s) 6,7 &9 Individual needs were being met because good arrangements for assessment and care planning existed. Systems were in place for consultation with service users but could be improved by establishing links with local advocacy services. Limited progress had been achieved with the implementation of risk assessments. Potentially service users may not be safeguarded. EVIDENCE: The manager had reorganised the files for each of the service users. There was a range of information and a new format for care plans had been introduced. One plan was examined and this covered the key themes relating to assessment of needs and the practical arrangements of meeting the day-today living needs of the service user. It was anticipated that care plans will be reviewed quarterly and each keyworker expected to prepare a monthly summary and review of service user’s needs. At staff team meetings, service user’s changing needs were discussed. Resident meetings were occurring and the manager made a commitment to attending these meetings. One of the service users was assisted in recording the minutes with staff support. From the records maintained, a combination of topics were discussed for example, holiday planning, planned activities and 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 9 staff ‘one to one’ times. It was advised that any action taken or feedback given at the residents’ meetings should be recorded in the minutes. There was no involvement by any advocacy agency. considered as an option in the future. This should be The manager recognised that risk assessments were not comprehensive and did not meet with the standards. Some work had already begun to highlight areas where risk assessments are either in place or need to be reviewed or to be introduced. The staff team were currently attending training to address this shortfall. Where appropriate, the manager informally sought the views and opinions of parent/s or relative/s regarding the service users. One family reported favourable comments about the regular contact maintained. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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) 16 The home’s ethos established the importance of each individual being treated with respect and dignity. Service users were invited to participate in decisionmaking and individual choices and lifestyle were preserved. EVIDENCE: Service user’s involvement in the home’s daily domestic routines was promoted. The staff team were committed to upholding service user’s privacy and dignity in all aspects of daily living. Service users were encouraged and supported to make decisions about their lives and influence the way the home was run. The manager was transparent about this commitment and filtered this to the staff team. Staff interactions were observed to be sensitive to the needs of people and were appropriately respectful. Service users were supported to open their own mail correspondence and this was consistent with care plans. All service user’s files documented their preferred form of address. Issues relating to smoking and alcohol were addressed in the terms and conditions of residence. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 standard(s) 18,19 & 20 Good care planning systems provided staff with adequate information to address health and social care needs. The lack of a comprehensive health care plan could potentially mean that some health care issues could be missed. There were satisfactory arrangements for the administration of medication. Although there was a shortfall in so far as staff were not following the home’s policy and procedure in maintaining accurate records. This could potentially place service users at risk. EVIDENCE: Two of the people living at the home only required minimal support with personal care. One person spoken to, particularly liked their en-suite bedroom as it provided ‘good privacy’. Care plans summarised individualised support in relation to personal hygiene, clothing and individual personal appearance. All service users were observed to be ambulant. The home did not have a specific document that fully addressed the overall health care needs of each individual although, since the last inspection, further improvements had been made to the provision of health care records. There was good evidence of regular appointments being attended at the opticians, dentists and GPs by service users. Further attention should be given to introducing a comprehensive health care assessment and plan that should address the entire health needs of individuals. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 12 The home had satisfactory arrangements in place for the administration of medication. Staff were provided with medication training. Records of service user’s medication did demonstrate gaps in relation to initials of the staff member when dispensing medications. The manager had raised this with the staff team collectively and had implemented ‘work colleague monitoring’. However the records sampled demonstrated a considerable number of gaps had occurred across the month of May 2005. It is strongly advised the working practice in relation to the dispensing of medication is reviewed to ensure accurate recording. The proper administration of medication to service users cannot be safeguarded if this practice continues. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 & 23 Certain service users felt if they were unhappy they were confident they would be heard. There were individuals who would not readily or easily use the complaints system. The complaints system inaccessibility could potentially exclude service users views being sought and acted upon. The Vulnerable Adult Protection records should improve to guarantee effective monitoring by the manager. EVIDENCE: The home had a policy and procedure for complaints. A record of complaints was maintained at the home. Since the last inspection no complaints had been logged. Service users were provided with information in the ‘Statement of Purpose’ and the ‘Service User Guide’. The manager stated that further adaptations were planned for the complaints procedure to ensure that it was more accessible for service users. This was anticipated to be available in September 2005. The manager operated an open door policy whereby any person could approach the home if they wished to raise a concern or query. In discussion with one service user they described that they could raise a concern or issue with any staff member. The staff team were clear about the expectation that some of the people living at the home would need additional support to readily use the complaints process. Last year there had been one Vulnerable Adult Protection investigation that was now fully resolved. This had partly contributed to a stressful period for the staff team and led to a period of instability for the staff group and it had affected staff moral. The new manager and the external line manager had provided extra support and further guidance. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 14 It is advised that the manager should implement a proper recording system at the home to clearly record all allegations and incidents of abuse in line with Standard 23. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 15 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 & 30 Service users were provided with a comfortable, homely environment but in places it looked tired and shabby. The home was kept clean although an infection control policy needed to be established. EVIDENCE: The home is a modern, spacious detached property located in a quiet residential area. The property has a nice secluded garden which was well maintained. One of the service users gave a guided tour of the premises to the inspector. The service user showed their own bedroom and it had suitable furnishing and a range of personal possessions. One room upstairs that was identified for the use of activities was essentially being used as a storage room for disused equipment and furniture. It would be beneficial for the home to organise this room better. Overall the home was kept clean. The lounge carpet should be cleaned or replaced as it was badly stained. The general decoration was looking tired and consideration should be given to implementing a rolling programme of decoration. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 16 There was a small kitchen just immediately off the lounge that was currently not being used. Previously this part of the house provided a self contained flat. The manager was in the process of exploring if this kitchen could be dismantled and the room reused as another communal room for the service users. This would enhance the design and layout of the lounge room area by creating a more homely environment. One of the shower units needed new grouting. Another shower unit needed the shower curtain replacing. In the utility room, 4 litre cans of paint were being stored with other items on an open shelving unit. A more suitable storage arrangement should be organised for these items. The home does not have an infection control policy. The manager was advised to review the current arrangements for clinical waste disposal in line with health and safety legislation and guidance. Records were sampled in relation to health and safety checks and fire checks and were shown to be current. The manager was in the process of updating and reviewing all environmental risk assessments. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: None of these standards were assessed on this occasion. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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) 42 The arrangements for health and safety were adequate. Health and Safety featured in staff training and safe-working practices were promoted at the home. EVIDENCE: The manager ensured that all staff received training to include fire safety, food hygiene and health and safety training. New staff covered these topics as part of the induction programme organised by the Royal Mencap Society. The manager ensured that cleaning products complied with Control of Substance Hazardous to Health (COSHH) and corresponding data control sheets were available. There was regular material supplied to the home in relation to guidance and direction of health and safety matters. All Royal Mencap homes had an extensive health and safety annual risk assessment for the home. Significant finding and actions were recorded to be monitored and reviewed. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 19 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 x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 2 Standard No 11 12 13 14 15 16 17 x x x x x 3 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 120 Feckenham Road Score 3 2 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 20 YES 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 YA1 Regulation 5 Requirement A service user’s guide, which includes all the information detailed in Regulation 5 and Standard 1, must be available in the home and copies must be given to all current, and any prospective, service users and their families. (Previous timescale not met (31/8/04). The service users contract (Licence Agreement) must be amended so that it includes all of the information detailed in Standard 5.2 (Previous timescale not met (31/8/04). A copy of the home’s complaints procedure must be given and/or explained to each service user and/or their relatives in an appropriate language/format including information for referring a complaint to the CSCI at any stage should the complainant wish to do so.(Previous timescale not met (31/8/04). All of the items of furniture specified in Standard 26.2 must be provided in rooms occupied by service users. If the provision of any item poses an E52 S18481 120 Feckenham Road V230409 310505.doc Timescale for action 31.8.05 2. YA4 5 31.08.05 3. YA22 22 31.08.05 4. YA26 16 31/8/05 120 Feckenham Road Version 1.30 Page 21 5. YA26 12 6. YA29 12 7. YA30 13, 16 8. YA41 17 9. YA19 12 10. YA 20 17 11. YA 23 13,16 unacceptable risk to the service user or they decline the provision, details of the discussions and decision about this should be recorded in the assessment of the service user’s needs.(Previous timescale not met (30/9/04). A lock, with an appropriate override device, must be fitted to the door of the service users bedroom on the ground floor(Previous timescale not met (30/9/04). Opportunities and/or equipment must be provided to enable two of the service users to develop their communication skills(Previous timescale not met (31/9/05). Policies on the control of infection must be drawn up to include the safe handling and disposal of clinical waste, dealing with spillages, provision of protective clothing and hand washing (Previous timescale not met (30/9/04). All the records that are required to be kept must be fully and accurately maintained in accordance with Regulation 17 and Schedules 1, 2, 3 and 4. (Previous timescale not met (31/8/04). The registered manager must ensure that a proper health care plan exists to fully comply with all the elements of Standard 19. The registered manager must ensure that all of the MAR (Medication Adminstration Records) accurately records all the medication dispensed by staff. The registered manager must ensure a record is maintained of 31.08.05 31/08/05 31/8/05 31/08/05 31/10/05 31/10/05 31/10/05 Page 22 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 12. YA 24 16 13. 14. 15. 16. YA24 16 all allegations and incidents of abuse and action taken in accordance with Standard 23.3. The registered manager must organise more suitable storage arrangements in the laundry room and the upstairs spare room. The stained carpet in the sitting room must be professionally cleaned or replaced. 31/8/06 31/10/05 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. 3. Refer to Standard YA5 YA10 YA14 Good Practice Recommendations The contract (Licence Agreement) should be in a format that is appropriate to the service users needs. The home should give a statement on confidentiality to partner agencies setting out the principles governing the sharing of information As part of the basic contract price, the option of a minimum seven-day annual holiday outside the home that the service users help choose and plan, should be stated clearly in the contract. The service users responsibility for housekeeping tasks should be specified in the service users’ guide. The home’s rules on smoking, alcohol and drugs should be clearly stated in the contract. All external preparations should be dated when opened A copy of Worcestershire’s policy and procedures on the Protection of Vulnerable Adults from Abuse and a copy of the Department of Health publication ‘No Secrets’ should be obtained for appropriate reference. A policy and procedure regarding service users money and financial affairs that incorporates all of the issues referred to in Standard 23.6 should be introduced. The registered manager should organise involvement of a local advocacy service to consult further with service E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 23 4. 5. 6. 7. YA16 YA16 YA20 YA23 8. 9. YA23 YA7 120 Feckenham Road 10. 11. 12. YA8 YA20 YA24 users. The registered manager should ensure that residents meetings clearly record any action taken or feedback given at the meetings. All staff who administer medication should undertake additional training in the safe control and handling of medication. A programme of routine maintenance and renewal of the fabric and decoration of the premises should be produced and implemented. 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 Page 24 Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 120 Feckenham Road E52 S18481 120 Feckenham Road V230409 310505.doc Version 1.30 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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