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Inspection on 14/07/05 for Watcombe Circus Care Home

Also see our care home review for Watcombe Circus Care Home for more information

This inspection was carried out on 14th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The staff group support the residents to live as independent life as possible and enable residents to access a variety of leisure activities. The home provides a safe and homely environment for residents, where they can develop independent living skills.

What has improved since the last inspection?

Residents are now involved in reviewing support plans and staff provide one to one time that includes residents going out for meals to places of their choice.

What the care home could do better:

The registered person must work more closely with social services to ensure that all residents placed at the home are correctly placed and when if identified as not correctly placed act promptly to ensure alternative accommodation is sought. Where residents self medicate risk assessments must take place to minimise the potential risk of self-harm. The registered person must provide the Commission with information on when the refurbishment is going to take place at Watcombe Circus.

CARE HOME ADULTS 18-65 Watcombe Circus Care Home 2-4 Watcombe Circus Carrington Nottingham NG5 2DT Lead Inspector Susan Lewis Rob Cooper Unannounced 14th July 2005 at 10:30 am 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. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Watcombe Circus Care Home Address 2-4 Watcombe Circus Carrington Nottingham NG5 2DT 0115 847 9335 0115 847 9335 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) Nottingham Community Housing Association Ms Nicola Louise Turner Care home 14 Category(ies) of LD Learning disability x 14 registration, with number of places Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 11 January 2005 Brief Description of the Service: Watcombe Circus is a large property that has been adapted from two semidetached buildings. The home offers accommodation up to 14 residents and provides care for people with Learning Difficulties. The home is sited in a residential area and has access to bus routes to the city centre. There are local shops, a post office, churches and other community facilities within walking distance at Sherwood. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4 hours and was part of the annual inspection process. A partial tour of the building took place and only residents’ records were inspected due to the manager being on annual leave. Residents and staff were spoken with during the inspection. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 3 Not all residents are assured that their needs will be met and residents are placed at potential risk where they are inappropriately placed. EVIDENCE: Three support plans were viewed as part of this inspection. The first plan viewed was of an exceedingly high standard, well ordered with all support plans in place to promote the residents independence. The second plan although not as detailed as the first did provide information regarding the resident’s social care and health care needs. The third care plan was poor, this did not provide clearly or concisely how the needs of the resident were to be met. This was particularly concerning as this plan was for the resident previously identified as being inappropriately placed and who had significant care needs. An immediate requirement was left regarding this resident, as requirements have been left on two previous occasions and not met. The manager must ensure that arrangements are made for the resident to move to more suitable accommodation and keep the Commission informed as to the progress. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 7 Individual plans do not always address needs. Residents are at potential risk where inappropriate placements have been made. EVIDENCE: As previously mentioned the support plans varied significantly in quality. This meant that some residents had full and detailed support plans others did not. It was clear from two of the plans as to what restrictions if any were placed on the residents. There were clear risk assessments identifying if they may possibly aggressive or self-harm. One resident’s plan who had previously transferred to supported living had returned to Watcombe, as the placement had not been successful. However this resident is also inappropriately placed and there appeared to be no evidence of discussion taking place between the home, the resident and social services as to the next move. The resident had been back at the home for over six months. This placement is placing other residents at risk. There is evidence that residents where possible are involved in drawing up and reviewing care plans. This had been a requirement at the last inspection and is now considered met. It is Nottingham Community Housing Association’s policy to print off support plans regularly or when they are updated, it was clear from the third support plan viewed that this practice Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 9 is not always followed. The registered manager must ensure where this is a policy within the organisation that this is followed. Some support plans were able to demonstrate where residents made choices; an example of this was where residents had gone on holiday. Support plans were seen for supporting residents with finances. Residents spoken with confirmed that they were able to exercise choice over their lives and were supported by staff. Staff spoken with were aware of support plans and the needs of residents. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14, 15 and 16 Lifestyle choices and opportunities for leisure activities are varied and appropriate. Service users feel respected and encouraged to be part of the local community. EVIDENCE: Support plans evidenced that residents are involved in a number of different leisure activities and residents spoken with confirmed this. Staff have one to one days with residents where they support residents in a chosen activity. This has recently been extended to include the staff member supporting a resident to go out for a meal at a venue of their choice. Evidence for this taking place was seen in the resident’s daily log on the SuRe computer system. The home has a car to support residents in shopping trips and residents spoken with said they liked going out shopping. Staff spoken with confirmed that residents are encouraged to maintain family links and friendships outside the home. On the day of the inspection a resident had a friend visiting, and residents were seen to be coming and going around the home attending various activities. Residents spoken with said that staff do not enter their bedrooms without knocking and their privacy is respected. Residents said that they receive their mail unopened or staff reported residents who need support with their mail receive it. Residents are involved in a variety of housekeeping tasks such as laundry cooking and cleaning. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 20 and 21 Residents are placed at potential risk where risk assessments are not carried out regarding their ability to self medicate. EVIDENCE: Personal support needs are detailed in the individual plans. Visits to various medical appointments are recorded and details what support is needed. The information that residents have been involved in providing regarding their wishes should they die is of a very high standard and clearly indicates that residents have been involved in this part of their support plan. Medication was not inspected in detail, however it was noted on one resident’s file that they self-medicated, but there was also mention that this person threatened to take all their medication. There was no risk assessment regarding this person’s ability to self-medicate and what action needed to be taken to minimise any risk their may be. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 12 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 and 23 Service users are aware of how to make their views known. Staff protect service users. EVIDENCE: The Nottingham Community Housing Association has a robust adult abuse policy and procedure as well as the Nottinghamshire Protection of Vulnerable Adults Procedure. Staff receive training as part of their induction in Adult Abuse awareness. Residents spoken with knew who to complain to and said they felt safe. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 13 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 and 30 A homely environment is provided, which is comfortable and safe. Bedrooms suit the needs of individual service users and sufficient shared toilets and bathrooms are available. EVIDENCE: The environment is homely and the furniture appears comfortable and of a high quality. The service users bedrooms are clean, personalised and decorated to a reasonable standard. Service users spoken with said that they are satisfied with their individual rooms. The home is on three floors and staircases access upper floors. There are grab rails to the stairs, but no lift. Service users are used to using the stairs to their bedrooms. The home was found to be clean and fresh on the day of the inspection. The laundry is still without hand washing facilities, although plans for the refurbishment were seen no date has been set for the start of this. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 14 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) 33 Staff are employed in sufficient numbers to meet the needs of residents. EVIDENCE: As the manager was on annual leave on the day of the inspection the staff supervision files and training records could not be inspected. Staff rotas were seen and showed clearly how many staff were on shift, during the course of the day it was evident that there were enough staff to meet the needs of the residents with extra staff provided if any one to one activities were planned. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 15 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, 39, 41 and 42 The overall management of the service safeguards the best interests of service users. Residents’ views and comments are valued and health and safety is promoted within the environment. EVIDENCE: The manager has been registered with the Commission since the last inspection. Staff and residents meetings are held regularly and evidence for these meetings was seen. All records seen were up to date and kept in a secure environment in accordance with the Data Protection Act 1998. Health and safety checks are carried out with up to date risk assessments for safe working environment, fire drills are regularly carried out. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 1 2 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 2 Standard No 11 12 13 14 15 16 17 x x x 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Watcombe Circus Care Home Score 3 3 1 4 Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 3 x C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 17 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 2 and 3 Regulation 14 Requirement Timescale for action Immediate (A date must be agreed with Social Services for the transfer within the next seven days.) 2. 6 13 The manager must ensure that accommodation is not provided to a service user at the care home unless, the registered person has confirmed in writing to the service user that having regard to the assessment the care home is suitable for the purpose of meeting the service user’s needs in respect of health and welfare. The manager must ensure the identified service user is to suitable accommodation to meet their needs. (Previous requirement at the last two inspections.) The registered person shall 1/09/05 ensure that residents are not placed at risk unnecassary risk. The registered manager must liaise with social services and make arrangements for the identified resident to find more appropriate accommodation. Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 18 3. 20 13 4. 30 13 The registered person shall ensure that unnecassary risks to health or safety of residents are identified and so far as possible eliminated. Where the resident self medicates and maybe a suicide risk a risk assessment must take place. The registered person must ensure that hand washing facilities are provided in the laundry. Immediate 25/07/05 NCHA must provide a date for the refurbishm ent. 5. 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 Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Edgeley House Riverside Business Park Nottingham NG2 1RT 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 Watcombe Circus Care Home C53 C03 S2258 Watcombe Circus V239031 140705 Stage 4.doc Version 1.40 Page 20 - 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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