Inspection on 09/12/05 for 120 Furber Road

This inspection was carried out on 9th December 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

120 Furber Road 13/11/06

120 Furber Road 07/06/05

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 Bristol BS5 8PT Lead Inspector Sandra Jones Unannounced Inspection 09:30 09 December 2005 th 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 120 Furber Road Address St George Bristol Bristol BS5 8PT 0117 9352157 0117 9709305 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) Aspects and Milestones Trust Ms Carol Mary Halton Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 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 7th June 2005 Date of last inspection 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. 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 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 DS0000026631.V263767.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection for the year 2005/06. Relatives’ views on the standard of care were sought on behalf of the residents during the inspection. One member of staff was consulted on the conduct of the home. Records, policies and procedures were examined to establish the standards of care. A tour of the premises took place during the inspection to ensure the environment is safe for the residents. What the service does well: What has improved since the last inspection? Since the last inspection, the manager has organised regular routine maintenance of the garden. The use of shared space has been adapted to 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 6 allow small groups and individuals to have quiet space that is additional to bedrooms. Members of staff are registered onto vocational training with the manger undertaking the Registered Managers Award. 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 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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): 1&4 The Statement of Purpose must include the systems to be introduced with the appropriate timescales, for potential residents to have an updated overview of the home. The emergency admission procedure must be included within the Statement of Purpose to inform potential residents, their representatives and funding agencies. Within the admission procedure, the commitment towards representative involvement must be incorporated. EVIDENCE: Since the last inspection, the manager has updated the Statement of Purpose. As the manager intends to update systems for developing the way residents’ needs are met, there are elements missing from the Statement of Purpose. The intended systems with timescales for completion can be incorporated into the Statement of Purpose - for example, reviewing care plans and arrangements for privacy and dignity. The Aspects and Milestones policy on admission in place indicates that referrals to the home are generally from the Local Authority. The policy stipulates that admissions to the home are based on full assessments from the funding agency. There is an expectation that potential residents visit the home on 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 9 three occasions including an overnight stay. It focuses mainly on finances, for example: Ongoing contracts, benefits and contribution towards the home’s vehicles. Within the Statement of Purpose, the admission process is listed and focuses on the intention to meeting residents needs. The commitment towards representative participation must be included in the policy. It is evident from the home’s procedures that emergency admissions are offered at the home. The arrangements for emergency admissions must be included within the Statement of Purpose. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 the following standard(s): 6&7 For residents to benefit from a person centred approach to their care, Essential Life Plans (ELP) need to be developed for each person. EVIDENCE: The front door was originally locked to prevent residents leaving the home without support. It was understood that this is no longer an issue and the requirement to complete a risk assessment is no longer appropriate. One Essential Life Plan (ELP) has been completed since the last inspection. This Plan contains essential information along with the individual’s preferences with personal care, safety and communication needs. The information thus far is detailed and guides the staff to meet the needs identified. Additional information regarding the individual’s social, emotional and intellectual needs must be included to meet all aspects of the person’s life to provide a realistic picture of the person with an action plan to meet the identified needs. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 11 For other residents their care plans are not as detailed and care planning processes must improve. This acknowledges that ELPs will improve the care planning systems. Care plans are currently monitored on a monthly basis by key workers. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 the following standard(s): 12, 15 & 17 Residents currently accommodated participate in appropriate activities within the community. Visitors to the home are welcome, enabling residents to maintain family links and friendships. The arrangements for visitors must be included in the Statement of Purpose. Residents have varied and nutritious meals prepared by the staff. EVIDENCE: Three residents have structured day care provision. One resident currently purchases day care provision from the Trust, which consists of 1:1’s for two hours per week. Another resident attends day care centre each day and the third person has day care provided by a Trust. Members of staff arrange community activities for the resident that remains at the home. These include contact with friends, hydrotherapy, shopping and Drop in centres. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 13 The visitors book is generally used by professional to record the date and nature of their visits to the home. Relatives giving feedback during the inspection confirmed that visitors to the home were welcome. The visitors made additional comments endorsing that visits can be conducted in shared and personal space. Visiting arrangements are not yet included in the Statement of Purpose. A record of food provided is maintained and indicates that three meals are served at the home, illustrating that residents have a varied and nutritious diet. There is a standard breakfast, light lunch and a cooked meal in the evening with smacks in between meals. At the time of the inspection, there was a wide range of fresh, frozen and canned goods. To comply with food safety, a record of fridge and freezer temperatures is maintained along with the temperatures of cooked meat. It transpired during the inspection that the oven door needed repair and to prevent injury to members of staff the oven was not used until the repairs were completed. During the inspection, residents were observed enjoying their lunch. Members of staff assisted residents with their meals and to meet residents’ preferences alternatives meals were prepared. The requirement made at the last inspection for risk assessments to be completed to establish residents’ abilities to have keys to their bedroom has not been actioned. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 the following standard(s): 18, 19 & 20 Essential Life Plans that describe the persons daily routines for personal care needs must be devised to ensure that residents preferred schedules are followed. For the resident that attends day care services, risk assessments must be completed to ensure the methods used are positive. The healthcare needs of the residents are assessed and guidance given by health and social care professionals is followed. Safe practices for the administration and recording of medications exist at the home. EVIDENCE: For the resident with an ELP, daily routines schedules were developed which are specific and clear about the individual’s personal care tasks. For other residents, personal care needs and routines are held in the ‘’Bank Folder’’. While this information is adequate, in terms of the individuals’ needs and the ways of meeting the needs, ELP’s must be devised. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 15 One resident that may not rise in time to attend day service has pillows and duvet removed if they are in danger of missing this. The inspector was informed that if this person missed this service they will be upset. Risk assessments must be completed to evaluate the activity, denoting the decisions reached to justify that the actions taken are positive and benefits the person. Daily diaries report on the times that residents got up and went to bed. Records confirm that residents rise at their preferred times or are awoken by staff to attend day services. Handling belts and chair hoists in the bathroom are used at the home to support residents with moving around the home and getting in and out of the bath. Risk assessments for safety harness and handling belts are completed for residents that require support with moving around the home. Occupational therapists and physiotherapists visit the home to advise on mobility. Risk assessments and ELP’s confirmed that professional guidance is followed. Professionals from the CLD team and social workers maintain some involvement with the residents currently accommodated. Residents access NHS healthcare facilities. The chiropodist visits the home regularly and during the inspection the local optician was undertaking optical checks at the home. Although residents are invited for routine screening, it is not appropriate because of their level of understanding. For this reason referrals are made for hospital appointments as medical issues arise. The procedure for expected and unexpected deaths was updated by the Trust and policies that relates to Death and Dying are in place. Medication profiles are in place and describe the preferred routine, the purpose of needs and side effects. For residents that have “when required” medications, profiles detail their purpose. Generally residents are prescribed analgesics and sedatives for medical procedures, which are administered when necessary. Members of staff sign medication administration sheets to confirm that medications were administered to residents. Medications held within the secure cabinet were consistent with the administration records sheets, supporting that staff sign the record immediately after administration. A record of medications no longer required at the home is maintained. To indicate receipt of the medication for disposal, the pharmacist countersigns the record. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 the following standard(s): 22 & 23 The manager acts upon complaints made by representatives on behalf of the residents. POVA training has raised staff’s awareness and responsibilities towards safeguarding residents from abuse. EVIDENCE: There no complaints received at the home or CSCI for investigation since the last inspection. The representatives of a resident reported that the manager or the Trust would be approached with complaints. The representatives were positive about the manner in which previous complaints had been managed by the Trust. Members of staff must attend POVA training organised by the Trust and there is an expectation that staff undertake annual updates. A member of staff giving feedback stated that the POVA training has clarified the forms of abuse and benefited vulnerable adults. The manager has completed specific POVA training organised by the Local Authority for managers and providers. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 the following standard(s): 24, 26, 27, 28 & 30 To improve the safety of the environment, repairs to the kitchen must be undertaken. Bedrooms are suitable to meet residents’ needs and their individual lifestyles. En-suite rooms and the ratio of bathrooms provide residents with personal privacy. The home provides a variety of shared space for residents to sit together as one group or in smaller groups. The home is clean and free from unpleasant smells. EVIDENCE: The property is located in a quiet residential area in St. George close to shops amenities and bus routes. It is a bungalow extended to provide accommodation to five people. There is level access into the home and is wheelchair accessible. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 18 Shared space is at the centre of the bungalow with bedrooms at either end. Bedrooms, lounge, conservatory and dining room are adequately decorated. Accommodation is arranged into single bedrooms and the Statement of Purpose details room sizes. It is evident bedrooms sizes are above the NMS of 10 sq.m. Bedrooms contain a combination of the home’s furniture and personal belongings for residents to fulfil their lifestyles. Three bedrooms have wet rooms installed and two bedrooms have toilets and bathrooms adjacent to their rooms. There is a full bathroom at either end of the bungalow with a ratio of 1:1. Both are assisted, with handrails for the toilets to ensure residents with mobility impairments can use the facilities independently. Shared space consists of a lounge, dining room and conservatory. The purpose of the conservatory has changed since the last inspection. Meals are eaten in the conservatory and the dining area is now used as a quiet area. The lounge and conservatory has sufficient seating for the residents to sit together. There is a utility room sited away from the kitchen and is equipped with washing and drying appliances, sluicing and COSHH substances. The wall finishes and floor covering can be washed easily. There is a sink installed, the washing machine and tumble dryer are domestic size. Risk assessments are in place for the chemicals kept in the COSHH cupboard and generally there are domestic substances - for example, furniture polish. The kitchen is worn and worktops are cracked and require attention. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 19 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): 34, 35 Residents are not yet fully supported and protected by recruitment policy and practice. The training provided at the home complies with legislation and ensures that staff are competent to meet residents changing needs. EVIDENCE: Training needs are assessed at each staff’s annual Personal Development Plan and through supervision. This assessment is based on performance, personal development and needs of the residents. Statutory training for staff at the home includes Fire training, Manual handling, Food Hygiene and First Aid. In-house medication training is presented by the manager, supplemented by the pharmacist and provided annually. Epilepsy, Loss and Bereavement training is completed by the staff. Other courses specific to residents needs which are undertaken by the staff include Understanding Autism and Supporting the Elderly. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 20 Two staff members are undertaking NVQ level 3 and five staff are registered onto the training. Member of staff on duty during the inspection described the training available and commented that in-depth awareness in increased and creating a culture of acceptance. Additional comments were made confirming the arrangements in place for consistency of care. It was reported that supervision, staff meeting and handovers are systems in place that ensure the standards of care are maintained. The requirement made at the last inspection for the manager to receive information and documentation about bank and agency staff that ensures their suitability to work with vulnerable adults has not been actioned. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 21 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): 42 The environment complies with almost all aspects of other legislation for the safety of the residents and staff. EVIDENCE: The records that relate to fire safety policies, procedures, checks and practices were examined. It was noted from the records that checks and practices are undertaken at the stipulated frequencies. Health and Safety checks are conducted at the home. Arrangements are in place for the Transfer of Waste and certificates to confirm Gas Safety checks were undertaken by an outside contractor. Portable equipment is checked and the certificate is up to date. The certificate for the hoist is out of date. The hoist must be checked to ensure the safety of the residents that use the equipment. 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 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 X 2 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 2 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 120 Furber Road Score 2 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X 2 X DS0000026631.V263767.R01.S.doc Version 5.0 Page 23 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation YA16 13(4) Requirement Risk assessments must be completed to establish residents’ abilities to have their bedroom keys. (Previously required 7/05/05) For bank and agency staff, the manager must receive information and documentation that ensures their suitability to work with vulnerable adults. (Previously required 7/05/05) The Statement of Purpose must include:a) the systems to be introduced with timescales. b) The arrangements for visitors. The admission procedure must contain the involvement from representatives. Essential life plans must be developed for each resident. Within the plans daily routines must be incorporated. Risk assessments must be completed for one resident that requires support with rising each morning. The oven door and worktops must be repaired/replaced. DS0000026631.V263767.R01.S.doc Timescale for action 30/03/06 2. YA34 19 (2) 01/03/06 3. YA1 4(1)(c) Sch.1 30/04/06 4 5 YA4 YA6 4(1)(c) Sch.1 15 30/04/06 30/06/06 6 YA9 13(4)(b) 30/03/06 7 YA24 23(2) 28/02/06 120 Furber Road Version 5.0 Page 24 8 YA42 13(5) A competent person must service the hoist. 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 120 Furber Road DS0000026631.V263767.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Bristol North LO 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 DS0000026631.V263767.R01.S.doc Version 5.0 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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