Inspection on 07/06/05 for 120 Furber Road

This inspection was carried out on 7th June 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 but made no statutory requirements on the home.

Other inspections for this house

120 Furber Road 13/11/06

120 Furber Road 09/12/05

120 Furber Road 06/12/04

120 Furber Road 05/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 120 Furber Road St George Bristol BS5 8PT Lead Inspector Sandra Jones Unannounced 7 June & 20 July 2005 09:30 th th 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 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 120 Furber Road Address St George Bristol BS5 8PT 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) 0117 9352157 0117 9709305 Aspects and Milestones Trust Mrs Carol Halton PC Care Home 5 Category(ies) of LD Learning disability (5) registration, with number LD(E) Learning dis - over 65 (5) of places 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 3 persons aged 50 years and over with learning disabilities May accommodate up to 5 persons aged 65 years and over with learning disabilities Date of last inspection 6-Dec-2004 Brief Description of the Service: 120 Furber Road is operated by Aspects and Milestones Care Trust and is registered to provide accommodation and personal care for 5 men and women who have learning difficulties between the ages of 50 to 65 years and over. Currently there are 3 women and 1 man residing at the home. The property is situated in a quiet residential street in St George, on the outskirts of Bristol and close to the South Gloucestershire boundary. There are local amenities within walking distance, and both Bristol and Bath bus routes are close by. The shopping and leisure facilities of Hanham, Kingswood, and Longwell Green are all near by. 120 Furber Rd is a bungalow, set back from the road. The premises has been extended to add a fifth bedroom, and to provide en suite facilities to three bedrooms. There are garden areas to both the front and back of the property. The home is wheelchair accessible. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted as an unannounced inspection over two days in 2005. One resident was not prepared to feedback on the standards of care and the others are unable to verbalise their thoughts. Interaction between residents and staff was directly and indirectly observed. Records were examined as a means of making judgements on the standards of care in place at the home. There were no additional visits to the home since the last inspection. What the service does well: What has improved since the last inspection? What they could do better: The Statement of Purpose and certain policies and procedures need to eb updated. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 6 Arrangements must be made for the regular maintenance of the garden, as neighbours sometimes make judgements on the standards of care by the appearance of the property. The manager must register onto the NVQ level 4 and Managers Award. 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 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 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 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 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 & 3 The manager must ensure clarity about the services and facilities offered by updating the Statement of Purpose. Training provided indicates that members of staff have the skills and capabilities to meet the residents range of needs. Issues that relate to two particular residents and their surrounding environment are being dealt by the Trust and outside agencies. EVIDENCE: The prepared Statement of Purpose describes the facilities and services offered at the home. The document requires updating and a condition of registration was imposed for the manger to review the document as part of the “fit persons’ process”. Further information must be added regarding the current manager and the specific skills and capabilities of the staff to meet the residents needs. Two residents currently have continuing issues in terms of the local environment, accommodating their communication needs. Outside agencies, placing authorities and the Trust are in discussion about the local community meeting their needs. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 9 Residents currently accommodated have communication needs, some physical impairment, and visual and severe learning disabilities. Awareness training from the RNIB was provided to create empathy and in the past communication training was provided. Manual Handling and Values Training ensures that staff have the skills to meet the residents range of needs. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 10 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 Essential Living Plans (ELP) are to be developed for each person. Reports of significant events contained examples of residents making decisions. Once ELP’s are in place, residents means of communication will be described. Risk assessments for locking the front door must be completed. EVIDENCE: Generally reviews are convened by the placing agency and from the care plan developed by the care manager an action plan is developed. Diaries describe the actions taken and keyworker reviews report on the success of the plan. In future Essential Living Plans (ELP) will be developed once the staff have received guidance from a facilitator. This standard will be further examined at the next inspection. It was understood that the members of staff observe residents body language to assess day-to-day decisions. ELP’s will describe the communication needs, 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 11 likes and dislikes and preferred routines to clarify residents means of decision making. Reports of significant events describe choices and decisions made on a day-today basis by residents. For example, clothing, times to rise and retire. During the inspection residents were observed making choices about their meals. Two residents use facial expressions to communicate choices and vocal sounds by others. Members of staff are clearer on the way the other two residents make choices. Currently four residents have contact with their relatives and three have family involvement in their care. For residents that have no family involvement advocacy should be considered during their ELP review meeting. Risk assessments are in place for restrictions imposed on one resident. Whenever, this individual becomes aggressive access into the kitchen is restricted. The front door is bolted to prevent a resident from leaving the building without staff support. While it is accepted that appropriate action is taken by restricting access, risk assessments must be reviewed using the TILE format (Task, Individual Capabilities, Load and Environment) to ensure appropriate action. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 12 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) 13, 14 & 16 The staff support residents to participate in community activities and outings. Arrangements must be made by the organisation for the maintenance of the garden. Assessments must be made to establish the residents abilities and understanding of using their bedroom keys. EVIDENCE: Residents use the local shops, supermarkets, hairdressers, garden centres and Drop in Centres. Residents support local events i.e. Kingswood Festivals. Residents are registered on the electoral role. Three residents have structured day care packages and staff accompany residents outside the home. Residents require the support of the staff outside 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 13 the home and because of their level of physical impairments, wheelchairs and home’s transport are used in the community. Rotas are adjusted for 1:1’s and outings and trips can be arranged at weekends and outside working hours. The home’s garden is currently overgrown and therefore does not blend well with its local environment. It is unacceptable to expect the manager and members of staff to incorporate gardening into their duties, when the home is already short staffed. There is no expectation that residents participate in household chores because of their level of understanding. Bedrooms and bathrooms are lockable and keys to bedrooms are kept in the bedroom locks. While it is accepted that keys are accessible to residents, they are unable to understand the concept that having keys represent. An assessment of residents ability to use their bedroom keys must be conducted. The manager confirmed that although residents are unable to lock their bedrooms, there is an expectation that residents right to privacy is observed. Members of staff were observed engaging and stimulating residents at home. It was understood from the manager that the expectation of 1:1’s taking place in a range of locations an inclusive culture is created. Residents are non smokers and smoking is restricted to outside only. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 20 & 21 Safe practices for the administration and recording of medications exist at the home. Medication profiles must be updated to provide up to date information. Policies and procedures to be followed for expected and unexpected deaths must be updated. Arrangements are in place for residents diagnosed with terminal illness. EVIDENCE: Three residents have regular prescribed medications administered through standard bottles by the staff at the home. Records of administration indicated that staff sign the records immediately after administering the medication to residents. When required medications are administered as needed by the person and the records examined are accurate. A record of medications no longer required is maintained which the representative of the local pharmacist signs, to indicate receipt of the medication for disposal. Individual medication profiles in place require updating to ensure the information is up to date . 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 15 Policies and procedures that guide staff on the process to be followed in the event of a death at the home are in place. However, the policies and procedures are clearly out of date for expected and unexpected deaths. The manager reported that where possible existing residents with a terminal diagnosis are cared for at the home, with palliative support. One resident sadly died recently and the staff were able to care for this person at the home, with palliative care support. The manager undertook the funeral arrangements and family members attended the funeral. Standard formats that detail each persons “wishes” in the event of their death are in place. For two residents “End of Life” plans are in place and members of staff will have to make arrangements for one person in the event of their death at the home. The manager is encouraging members of staff to attend the Death and Bereavement training, as the staff were clearly upset about the recent death of a resident. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 16 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 The manager and staff take complaints received at the home seriously. A regular maintenance programme must be developed for the garden, to sustain good neighbourly relationships. Training provided ensures that the staff are aware of their responsibilities to safeguard residents from abuse. EVIDENCE: Three complaints were received at the home from neighbours, two were about the overgrown garden and one was about the vocal sounds of another resident. Environmental Health is involved in monitoring of the noise levels and the Trust has taken steps to maintain polite relationships with the neighbours. Complaints received are recorded, with the nature of the complaint and the actions taken. The level of satisfaction, which evidences that the outcome was discussed with the complainant, is not recorded. The level of satisfaction must be recorded and where appropriate the steps taken by the complainant if the person is not satisfied with the outcome. There is a rolling programme for staff to attend POVA training. The manager recently attended an external POVA workshop training and support workers attended the training organised by the Trust. The manager must consider attending the POVA investigators course, which augments the manager’s responsibilities towards a multidisciplinary approach to investigating POVA issues. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 17 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) These standards were not examined at this inspection. EVIDENCE: 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 34 & 36 Staffing levels meet the residents range of needs. Existing staff personnel records establish their suitability to work with vulnerable adults. Systems that determine the suitability of bank and agency staff must be introduced at the home. Members of staff employed at the home have individual supervision with the manager. The external manager visits the home regularly and undertakes individual supervision with the manager. Records must be provided to evidence Regulation 26 compliance. EVIDENCE: The rota in place indicated that two staff are rostered to work throughout the day, with one person waking person at night. An additional person is rostered to cover activities when required. The home must rely on bank and agency staff to cover vacant hours. For Aspects and Milestones bank staff, notification is received at the home that CRB’s are obtained for the person. However, the manager is not advised of the recruitment procedure followed, for establishing the person’s suitability to work with vulnerable adults. There is no systematic approach to establishing 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 19 agency staff’s suitability to work at the home. While it is acknowledged that confirmation is received by the agencies, used by the Trust that CRB’s are obtained for all staff the home is failing to determine the workers’ fitness. The manager must ensure that documents and information specified in Schedule 2 are obtained for the member of staff from the agency. Personnel files for staff employed at the home were examined and with the exception of a current photograph, the required information and documentation is held for each person. 1:1 supervision take place with the manager and each member of staff at 4-8 week intervals. From the records examined, supervision sessions are based on monitoring performance and personal development, preceded by annual personal development reviews. It was emphasised by the manager that the external manager visits the home frequently for 1:1 supervision with the manager. The records of the visits are not up to date. The external manager must report on the conduct of the home on a monthly basis and forward a copy of the report to the CSCI. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 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 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) 37,38,41&42 The manager was successful in the “Fit Persons” process. Members of staff comments were based on the managers’ positive approach to an inclusive culture. Records of cash, fees and fire safety are accurate and up to date. EVIDENCE: The manager has recently completed the “Fit Persons” process and conditions of registration were imposed as an outcome of the process. The manager must register the NVQ level 4 and Registered Managers Award, Update the Statement of Purpose and to maintain established practices for people with profound learning disabilities. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 21 Members of staff were consulted on the managers style of management. The members of staff reported that as vacant hours are covered, opportunities exist to support residents with pursuing their lifestyle. Keyworking, team meetings and supervision were the systems described, which ensure there is consistency of care at the home. Sharing information and seeking staff suggestions was felt to develop an open culture at the home. Access to training, including vocational, statutory and specific to meet residents needs is open to the staff at the home. Facilities for the safekeeping of cash and valuables exists at the home and residents have cash in safekeeping. From the records examined, records were consistent with the balances held in safekeeping. Fees are paid by direct debit from residents accounts into the Trust account. Individual schedules in place that list the sources that contribute towards the fees are in place. Form the records examined fees range from 1137.50 – 1374.65. Records that relate to fire safety policies, procedures, checks and practices examined, indicated that checks and practices are conducted at the stipulated frequencies. 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x 3 x x Standard No 22 23 ENVIRONMENT Score 2 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x 3 3 x 3 x Standard No 31 32 33 34 35 36 Score x 3 x 2 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 120 Furber Road Score x x 2 2 Standard No 37 38 39 40 41 42 43 Score 2 3 x x 3 2 x D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 23 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 Standard 1 Regulation Requirement Timescale for action 30/12/05 2. 3. Standard 9 Standard 16 Standard 20 Standard 21 Standard 22 4. 5. 6. 7. Standard 34 8. Standard 36 Regulation Review and update the 6 Statement of Purpose and add information about the current manager and qualifications of the staff. Regulation Risk assessments for locking the 13(4)(b) front door must be completed. Regulation Risk assessments must be 13(4) completed to establish residents abilities to have their bedroom keys. Regulation Medication profiles must be 13(2) updated. Regulation Procedures to be followed in the 12 event of an unexpected and expected deaths must be reviewed. Regulation a)External arrangements must 22 be made for the regular maintenace of the garden, b)Records of complaints received must include the complainants level of satisfaction. Regulation For bank and agency staff, the 19 (2) manager must receive information and documentation that ensures their suitability to work with vulnerable adults. Regulation Reports on the conduct of the 26 home must be available for inspection. D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc 30/9/05 30/9/05 30/9/05 30/10/05 30/8/05 30/9/05 30/9/05 120 Furber Road Version 1.30 Page 24 9. Standard 37 Regulation The manager must undertake 9(b)(i) vocational qualifications 30/12/05 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. Refer to Standard Good Practice Recommendations 120 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury South Glos. BS32 4RG 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 Furber Road D56_D05_S26631_120furberroad_V233845_070605_Stage4.doc Version 1.30 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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