Inspection on 05/05/05 for 121 Watley`s End

This inspection was carried out on 5th May 2005.

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

121 Watley`s End 14/05/07

121 Watley`s End 20/04/06

121 Watley`s End 26/09/05

121 Watley`s End 31/01/05

121 Watley`s End 11/08/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 121 Watley`s End Winterbourne South Glos BS36 1QG Lead Inspector Melanie Edwards Unannounced 5 May 2005 09:45 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. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 121 Watley`s End Address Winterbourne South Glos BS36 1QG 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) 01454 250232 01454 250994 admin@aspectsandmilestones.org.uk Aspects & Milestones Trust Mrs Carol Elizabeth Close Care Home Nursing for Younger Adults 14 Category(ies) of LD Learning disability registration, with number PD Physical disability of places 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 14 persons aged 18 years and over with learning disability who may also have physical disability and who require nursing care. Staffing Notice dated 20/07/2001 applies. Manager must be a RN on part 5 or 14 of the NMC register. Date of last inspection 31-Jan-2005 Unannounced Brief Description of the Service: Aspects and Milestones Trust operate 121 Watleys End Road, which is registered to provide nursing care to 14 adults with a learning disability and a physical disability. The property is located in a quiet residential area, close to local shops and amenities. There are 14 single bedrooms of various sizes, all of which have sinks. There are a parking spaces and grounds to the side and rear of the house. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Please note due to profound, multiple disabilities, the majority of residents are unable to express their views about the Home. The inspector observed staff assisting residents with their care needs, and was also able to discuss with five care staff and one registered nurse their roles and responsibilities. Staff were seen spending time with residents, talking to them, and it was apparent that staff work hard to try and develop ‘warm’ trusting relationships with residents. A selection of records relating to the day to day running of the Home, as well as care records were inspected The Home was viewed throughout, and residents looked comfortable and relaxed. What the service does well: What has improved since the last inspection? What they could do better: Updating the Statement of Purpose and Service User’s Guide to reflect the change of manager and the correct details of the Commission for Social Care Inspection would ensure that this meets the Care Homes Regulations 2001. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 6 To minimise the risk of infection a more suitable storage facility for fruit and vegetables should be found so that it is not stored on the cupboard floor along with the cleaning mop and bucket. Prioritising the review of residents plans of care so that they are all reviewed at the specified frequency will enable staff to ensure that the residents changing needs are met. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5, The Home provides prospective residents representatives with the majority of information needed to make an informed choice about the Home. The Home is also able to meet resident’s range of care needs. EVIDENCE: The inspector viewed a copy of the statement of purpose and service user guide; to see what information resident’s representatives are provided with. There was information included in both documents about the day-to-day running of the Home, the type of care provided, and the staffing levels and the training of staff. This information should assist resident’s representatives to make an informed choice about which Home they chose. However, the details for the current registered manager, as well as the name and contact details for the Commission for Social Care Inspection were not included in the service users guide. This information could be required if someone was trying to find out more about the Home, and how it is regulated. The staff the inspector met showed a good understanding, and sensitivity to, the complex heath needs of the residents in their care. Staff on duty, explained they relied on resident’s body language, gestures, and long-term knowledge of the residents to try and understand their needs. Staff communicated with residents using ‘humour’ and touch. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9 The Home meets the resident’s range of complex health and social care needs, and supports residents to live a varied and fulfilling life both in and out of the Home. EVIDENCE: To review the care that is provided, two resident’s care plans were inspected. The care plans contained a range of information, and included information showing how to support residents with a range of complex care needs. The care plans contained easy to follow information, and showed how best to assist the residents to meet their complex nursing care needs. Care plans also addressed psychological needs of the service users, and detailed how to support a resident if they seemed to be distressed or agitated. In each plan of care was a personal profile; staff had completed these profiles based on knowledge and observation of the residents. This included information such as what was important to the resident, as well as things they did not like. The range of information written in the care plans should help to ensure residents are supported to meet their needs. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 10 One of the care plans seen had been signed by a registered nurse and had been reviewed and evaluated on a regular basis, demonstrating the Home monitor the residents changing needs. The second care plan had not been formally reviewed for twelve months. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 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 standard(s) 13,14,16,17 Residents are provided with a healthy, balanced diet, and are supported to live a varied and fulfilling life both in the Home, and as part of the local community. EVIDENCE: The Home ensures residents are able to regularly visit the cinema, go out for coffee, as well as to nearby pubs, and other social venues thereby helping to ensure a varied and fulfilling life. There was also detailed information written in daily records that showed residents also access a range of community activities such as the shops, the pub or local activities centres. The inspector reviewed a copy of the current resident’s menu to ascertain if residents are being provided with a well balanced diet. There were choices of dishes recorded for each day and the menu was nutritionally well balanced, and varied. The community dietician regularly reviews the menu for its nutritional content. The lunchtime meal was seen being served; the meal consisted of a choice of freshly made macaroni cheese with fresh tomatoes, and bread and butter, or shepherd’s pie, demonstrating residents are offered a choice of meals. Some meals require being puréed, and these were being presented attractively. Staff were observed assisting residents with their meals in a 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 12 sensitive manner helping to ensure the meal was a relaxed and dignified experience. The kitchen area was inspected to see if food is stored and prepared in a safe environment .The kitchen was clean, tidy, and well organised in the majority of areas. However currently the area used to store fresh fruit and vegetables is also being used to store a mop and bucket. There was also a lack of storage shelves, and some vegetables were being stored on the floor of the room, which is potentially an unhygienic area, and as such an environmental health risk. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 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 standard(s) 18,19,20 The Home supports residents to meet their emotional needs in the way they believe residents prefer; there is a safe system in place for the handling and administration of resident’s medication. EVIDENCE: The procedures for the administration, storage and disposal of medication were reviewed to monitor the systems in place for the handling of resident’s medication. The medication administration charts of four residents were looked at in detail. There was a photograph of the resident maintained with each record, to ensure medication is dispensed to the correct person. The medication administration charts were legible up to date, and contained the signature of the dispensing registered nurse, demonstrating resident’s medication is administrated safely, the reasons for any omissions had also been written on the charts. Up to date records were also being kept of all medication being received into the Home, and medication being returned to the issuing pharmacy, showing there are safe systems in place to monitor how much medication is held in the Home. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 14 The inspector observed staff assisting residents with their care needs. Staff were seen responding to residents in a sensitive, patient manner and despite being busy staff were calm and unhurried in the manner they were assisting residents. In discussion with care staff it was clear that many staff had worked at the Home for over six years, and all staff the inspector met demonstrated they had a detailed understanding of the ways people use to express themselves, which should help to ensure that individual’s needs are met and their wishes are listened to. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 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 standard(s) 22,23 The Home aims to ensure residents are protected from abuse or harm, and there is a suitable system in place for representatives of residents to complain on their behalf. EVIDENCE: A copy of the procedure for resident’s representatives to make a complaint on their behalf is on display on the wall of one corroder, which is a well frequented part of the Home. The procedure includes the contact details for the Trust and the area office of the Commission for Social Care Inspection, if someone is not happy with the outcome of a complaint investigated by the Home. The inspector viewed the complaints record book, to ascertain how the Home responds to complaints. There had been no new complaints recorded since before the last inspection, the record did include the details of how the complaints were to be dealt with. There was evidence in training records showing staff had attended training on issues related to protection of vulnerable adults from abuse in the last twelve months. The Trust are clearly committed to ensuring staff are up to date in their understanding of the principle of the protection of vulnerable adults from abuse. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 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 standard(s) 24-30 The Home is clean, safe, and suitable for meeting the needs of residents who live there. EVIDENCE: 121 Watleys End Road is close to nearby shops and therefore residents can easily access local amenities. It is a ‘purpose built’ bungalow style property in a quiet residential area. The entrance of the building provides very easy access for wheelchair users and there is similar access to all areas. There are grab rails positioned along the corridors and manual handling lifting aids in bathrooms and toilets. The bathrooms are spacious in size to provide easy access and the baths are specially adapted to assist residents. The standard of the decoration and the quality of fixtures and fittings was satisfactory. Rooms had been furnished and decorated to reflect resident’s different interests. There were visual stimulation aids as well as relaxation aids such as wall lights and mobiles seen in many rooms to provide additional stimulation and relaxation for residents. Bedrooms were decorated in different colours and this helped to create an individual feel to rooms. There is a programme of redecoration of rooms being undertaken and staff said that they had to involve residents in this process, for example one member of staff went with one resident to a store to choose paint. The environment was clean, tidy and satisfactorily maintained. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 17 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 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) 31,32,35,36 Skilled and well-qualified staff, with a clear understanding of their roles and responsibilities, support residents in the Home. EVIDENCE: The inspector reviewed the staff duty record for shifts April 2005,to monitor the number of staff on duty to support residents to meet their needs. There was a minimum of seven staff on duty for a day shift, consisting of five care staff and one registered nurse and three staff at night consisting of one registered nurse and two care staff. The number of staff on duty for each shift met the minimum staffing numbers required by the Health Authority staffing notice under previous Care Homes legislation The training records demonstrated staff had completed training sessions relevant to the needs of the residents over the last twelve months. Staff are evidently committed to increasing their knowledge and understanding of health care issues that could relate to the needs of residents in their care. Staff also demonstrated that they communicate with and support residents in a sensitive manner, and work well as a team. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 19 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) 40,41,42 There are a range of policies and procedures to protect the rights and best interests of residents, and the health and safety of resident’s staff and visitors is protected. EVIDENCE: Records are kept in the office and this room is kept locked when not in use ensuring residents confidential information is held securely. Generally all the records reviewed were found to be satisfactorily maintained and in order. Other records have been referenced elsewhere in this report, demonstrating well organised management in the Home. The fire logbook record showed that the range of required fire safety checks were being carried out, and were up to date, helping to ensure the safety of people who are in the building. There are also monthly health and safety checks carried out of the environment, helping to ensure that the building is satisfactorily maintained. There are also a range of polices and procedures in place that support and guide staff in their care practises, health and safety matters, employment issues, and the general running of the Home. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. Where there is no score against a standard it has not been looked at during this inspection. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 121 Watley`s End x x 3 3 x Standard No 31 32 33 34 35 36 Score 3 x 3 x x 3 Version 1.20 Page 21 D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc 16 17 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x 3 3 3 x 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 22 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. 2. Standard 1 1 Regulation Schedule 1.1. 5.(f) Requirement The statement of purpose must include the relevant details for the current registered manager. The service users guide must include the correct name and contact details for the Commision for Social Care Inspection. The care plan identifed at the inspection must be reviewed and updated. Timescale for action By 19.05.05 By 19.05.05. 3. 6 15.2(b) By 05/05/05 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 17 Good Practice Recommendations Provide additional storage space for storing fruit and vegetables only. 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 23 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 121 Watley`s End D56 D05 S20258 YA 121 Watleys End Road V217443 260505 Stage 4.doc Version 1.20 Page 24 - 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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