Inspection on 18/03/09 for 130 Station Road

This inspection was carried out on 18th March 2009.

CSCI found this care home to be providing an Good service.

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

130 Station Road 14/03/07

130 Station Road 04/01/06

130 Station Road 07/09/05

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

Extracts from inspection reports are licensed from CQC, this page was updated on 18/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 130 Station Road 130 Station Road Sheffield South Yorkshire S13 7RB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Marina Warwicker     Date: 1 8 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: 130 Station Road 130 Station Road Sheffield South Yorkshire S13 7RB 01142939081 01142939082 none Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Milbury Care Services Ltd Name of registered manager (if applicable) Kirsty Taylor Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 130 station road is a house converted to meet the needs of three service users with learning difficulties and some mental health needs. The house is situated in the Woodhouse area of Sheffield. There is a regular bus service from outside the home and there is also easy access to the tram service. There are some shops within walking distance. The staff have access to the homes transport. The bedrooms are on two floors. The residents have access to all the shared areas of the home. There is a well-maintained private garden at the rear of the house. The fees for the accommodation and the support range from GBP1,650 to GBP1,850 per week. Care Homes for Adults (18-65 years) Page 4 of 28 care home 3 Over 65 0 0 3 3 Care Homes for Adults (18-65 years) Page 5 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is 2 star. This means that the people who use this service experience good quality outcomes. The last unannounced Key inspection of this service was carried out on 14th March 2007. We visited the home on 18th March 2009 at 2pm and this was an unannounced site Care Homes for Adults (18-65 years) Page 6 of 28 visit and the staff were not aware of it. On the day of the site visit we spoke with three staff and the manager. Following the visit two care staff and two relatives were contacted by phone to discuss the service provided at the home. The comments have been included in the body of this report. We would like to thank the management, service users and the care staff for their contribution to this report What the care home does well: What has improved since the last inspection? What they could do better: Copies of the original needs assessments by the placing authorities should be kept in the individual care files so that they are accessible by new staff. This will help staff find out the service users past history and progress made since moving into the home. Furthermore such information would help care staff with future planning of the support and the care. All staff must respect service users rights and only make changes through consultation with the service user.The care staff must ask service users permission before changing TV channels. This is to show that the care staff are visitors to the home and they need to gain permission before acting on behalf of the service users. The programme of activities arranged by or on behalf of the people living at the home must provide facilities for each individual by having regard to their needs in relation to education, fitness and training.This is to reduce the time the service users spend in isolation in their rooms and promote interaction and offer opportunities for them to socialise and learn social skills. Care Homes for Adults (18-65 years) Page 8 of 28 The key workers with the help of the manager should meet with the service users and their family and agree on decisions about the activities the service users should be participating in so that the best outcome could be achieved for the people living at the home. Although according to the records and the staff interviews we were informed that this happens but the families were not satisfied and therefore there needs to be consultation. All care staff should receive formal training on death and dying. Often death can be unpredictable and the staff should have skills to support people who may be dying and their relatives. . The management need to make sure that the service users and their families are kept informed of any changes to the staff team to avoid unnecessary uncertainty and anxiety among the people who use the service. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 1,2,4&5 People who may wish to use the service and their representatives have the information needed to make an informed choice of home. The people are able to visit the home and have trial periods. This helps the prospective service users to find out whether the staff at the home are able to meet their needs. Evidence: Copies of an up to date statement of purpose and a service user guide were made available at the entrance hall of the home for people to read and check the services available. On the day of our visit there was one vacancy. The two people using the service had been in the home for some years and they seemed settled in the home. We were informed by the manager that the original needs assessments by the placing authorities for the two service users had been archived. Comments made by the families highlighted that the new staff were not fully aware of the past histories and the complex needs of the service users; therefore it would be advisable to keep the Care Homes for Adults (18-65 years) Page 11 of 28 Evidence: assessments accessible to all staff at all times as a point of reference. The family members of the service users said that the home encouraged introductory visits and the service users were able to voice their opinions with regards to compatibility of any prospective service user. The two service users had copies of the terms and conditions agreement. These had been written in a format which was user friendly. They were signed by the individuals and / or their advocates. Care Homes for Adults (18-65 years) Page 12 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 6,7,8,9&10 Individuals are involved in decisions about their lives. Although they are encouraged by the staff to play an active role in planning the care and support they receive, the families of these service users are not convinced that the people are able to make the best decisions to help them make good progress due to their complex needs. Evidence: The two care plans were checked and the staff on duty were consulted. The records reflected the changing needs of the people using the service. One care staff said, Care files are reviewed each month following the multidisciplinary meetings. We make sure they are kept updated. The families know that they can ask to see the files anytime. One relative said, If I want to read the care files the staff will give them to me. I am happy attending the reviews and discussing the issues at the meetings. Care Homes for Adults (18-65 years) Page 13 of 28 Evidence: There was evidence that the service users were given opportunities and encouragement by the care staff to take part in activities. We saw how the care staff rewarded the service users for their positive actions to encourage progress. These reward plans had been agreed at the multidisciplinary case reviews . One of the staff said, If x wants to go out for a run in the car or go shopping, one of us will take her out. We help the people spend the day as they want to. Relatives of the service users said that in the past the people had been encouraged to participate in different activities and were kept busy most days. They commented that there was a lack of activities and this was due to the staff and management changes. Both family members said that the service users were allowed to do as little as they want and this has resulted in them spending too much time in their bedroom. We asked the families for their opinion of the service provided by the home, they independently said that it was a good home and that the care staff supported the service users and the service users were happy living at the home. We were informed by a relative that some staff did not ask permission from the service users before changing TV channels. Some staff demanded the service users to do things which they themselves often did not do. For example, saying please and thank you, asking the service users to wash their hands before touching food and the staff often did not wash their hands before their meals. We have informed the management of these findings so that they are able to take corrective actions. Risk assessments had been carried out to minimise risk and also to encourage the people to be independent. During the site visit we witnessed the care staff maintaining confidentiality of each service user by not discussing them in the presence of the other people. The care staff ensured that the individual records were kept safely in a cupboard. Care Homes for Adults (18-65 years) Page 14 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 11,12,13,14,15,16&17 People who use the service are generally able to make choices about their lifestyle. They are supported to develop their life skills. Social, educational, cultural and recreational activities could be reviewed to meet individuals expectations. Evidence: We spoke with the relatives of the service users, the staff, the manager and checked the documentation when concluding this outcome area. The care plan identified the activities in which the people liked to participate. There was a list of activities which took place each day. On the day of the site visit one of the people spent the day out with the family and the other service user had been out in the morning with a support worker. This service user was in her room when we arrived. We were informed by the Care Homes for Adults (18-65 years) Page 15 of 28 Evidence: care staff that she was resting after the morning outing. The other service user too went to her bedroom as soon as she returned from her day out with her family. The family members were worried that the service users were spending too much time in their own bedrooms and wanted to know whether the carers could find ways of occupying them. We have discussed our findings relating to this matter in the previous outcome area under Individual needs and choices. The staff and the family said that the daily routines were flexible to suit the needs of the two service users. Once again the family members wondered why people were allowed to stay in bed for too long. The families were made aware that the individuals choice had to be respected. One relative said that she would bring these issues up with the staff team at the next meeting. People chose what they wanted to eat and the staff encourage them to eat healthily. The staff had their meals with the service users so that they could lead them by example. We also saw weekly menus displayed in the dining areas to remind service users what they had planned to have. We were informed by the staff that service users sometimes bought cooked food from the local shops and that the service users enjoyed shopping and interacting with the local people. Care Homes for Adults (18-65 years) Page 16 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 18,19,20&21 The health and personal care that people receive is based on their individual needs. The principles of dignity and privacy for the service users are respected by the care staff at the home. Evidence: We observed the staff providing sensitive and flexible, personal support to maximise the peoples privacy, dignity,independence and control over their lives. The service users were able to wear what they wanted as long as it was safe and comfortable for them. The family members of the service users and the staff said that regular multidisciplinary case reviews were carried out to monitor progress. We witnessed a family member making arrangement to attend the care review and informing the service user about it. We also noted that the service users have had appointments with Care Homes for Adults (18-65 years) Page 17 of 28 Evidence: health professionals and that the care staff had made sure the service users attend the appointments by reminding them and encouraging them. Both service users had consented to having their medicine administered by the care staff. The care staff have had training and had been deemed competent to manage medicines on behalf of the service users. Regular audits had been carried out by the supplying pharmacist and the pharmacist had made very positive comments about the homes compliance. The care staff had not received any formal training on death and terminal care. One member staff said, I have looked after a dying person but I have not had any training. Discussions with the manager identified the need for the staff to attend training on this subject. Care Homes for Adults (18-65 years) Page 18 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 22&23 People who use the service are able to express their concerns and have access to the homes complaints procedure. The staff training and supervision promotes safety of people . Evidence: The people whom we consulted said that their views were listened to by the manager and the staff at the home and that they always tried to put things right. The care staff were able to verbalise the action they would take if there were to be any allegation of abuse. The staff have had training on Protection of Vulnerable Adults. Two staff said that they had received training on understanding and dealing with physical and verbal aggression by service users. One of the family members said that they were able to talk to the staff if they had any concerns and sought solutions. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 24 & 30 The physical design and layout of the home enables people who use the service to live in a safe, well maintained and comfortable environment, which encourages independence. Evidence: The home was homely, comfortable, clean and safe for the people live and work. Service users have a single bedroom and communal areas so that they are able to mix with others including staff and visitors. We interviewed staff to find out their understanding of Infection Control and the safe handling and disposal of clinical waste. The staff were up to date and confident in the procedures. Care Homes for Adults (18-65 years) Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 32,34,35&36 The staff working in the home are trained and on the whole skilled. They help with the smooth running of the service by being reliable. Evidence: We consulted the staff, checked the staff files and spoke to the family members to conclude this outcome area. The staff structure was clear and the care staff knew their responsibilities. The manager and the two senior care staff made the management decisions which were then passed on to the team. This was confirmed by the staff. The three staff files checked were fully compliant. The manager had an up to date training record which confirmed that all staff had received mandatory training. There were also plans for further specific training for staff . Staff had also received regular supervision and the records were also available for inspection. The staff said that supervisions were very useful and supportive. The comments made by the families about some of the staff have been discussed under the Individual needs & Choices outcome area. Care Homes for Adults (18-65 years) Page 21 of 28 Care Homes for Adults (18-65 years) Page 22 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. 37,39&42 The management and administration of the home is based on openness and respect. They have a quality assurance system to measure their service. Evidence: The home benefits by having a permanent manager. Two relatives said that the changeover of managers and the rapid turnover of care staff had not helped with the progress of the service users. They explained that each time the manager got to know the service user and built up a good rapport they seem to get moved on. They also said that the care staff too moved away as soon as they got to know the service users. One of the family members said that some care staff did not understand the complex needs of the individuals and that it was due to staff turnover. Our inquires confirmed that staff moved on to make progress in their careers and in some cases staff took on the post of a care worker whilst looking for a suitable career. We have informed the management about these concerns so that she is able to explain the reasons to the family. Care Homes for Adults (18-65 years) Page 23 of 28 Evidence: The care staff said that they took part in quality audits. The manager said that the responsible individual visited each month and prepared a report on the running of the home and she responded to the finding by submitting an action plan if it was needed. She then involved staff in resolving matters or made changes to the way they worked. The manager continues to promote the health, safety and the welfare of the people who live and work at the home by training the care staff and completing the necessary risk assessments. Care Homes for Adults (18-65 years) Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 12 All staff must respect service 30/04/2009 users rights and only make changes through consultation with the service user. The care staff must ask service users permission before changing TV channels. This is to show that the care staff are visitors to the home and they need to gain permission before changing channels on the TV. 2 8 16 The programme of activities 30/04/2009 arranged by or on behalf of the people living at the home must provide facilities for each individual by having regard to their needs in relation to education, fitness and training. This is to reduce the time the service users spend in isolation in their rooms and promote interaction and Care Homes for Adults (18-65 years) Page 26 of 28 organise opportunities for the service users to develop life skills. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 Copies of the original needs assessments by the placing authorities should be kept in the individual care files so that they are accessible to new staff. This will enable staff to find out the service users past history and progress made since moving into the home. Furthermore such information would also help with future planning of support and care. The key workers with the help of the manager should meet with the service users and their family and make an informed decision about the activities the service users should be participating in so that the best outcome could be achieved for the people living at the home. All care staff should receive formal training on death and dying. Often death can be unpredictable and the staff should have skills to support people who may be dying and / or their relatives. . The management of the home should keep the service users and their families informed of any changes to the staff team to avoid unnecessary uncertainty and anxiety among the service users. 2 11 3 21 4 37 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 28 of 28 - 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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