Inspection on 16/06/06 for 14 Norfolk Road

This inspection was carried out on 16th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

14 Norfolk Road 30/09/09

14 Norfolk Road 15/10/08

14 Norfolk Road 28/02/07

14 Norfolk Road 02/02/06

14 Norfolk Road 19/09/05

14 Norfolk Road 21/03/05

14 Norfolk Road 16/08/04

14 Norfolk Road 19/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 14 Norfolk Road Carlisle Cumbria CA2 5PQ Lead Inspector Cath Wilson Unannounced Inspection 12 June and 16 June 2006 10:00 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 14 Norfolk Road Address Carlisle Cumbria CA2 5PQ 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) 01228 592515 www.c-i-c.co.uk. Community Integrated Care Mrs Fiona Byers Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The home is registered for a maximum of 6 service users to include: up to 6 service users in the category of LD (Adults with learning disabilities) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 2nd February 2006 Date of last inspection Brief Description of the Service: 14 Norfolk Road is a detached three-storey property. Community Integrated Care provides the care and services. The home is registered to provide care for six people with a learning disability. Service users only use the ground and first floors, with staff accommodation on the top floor. It is situated in a residential street approximately one mile from the City of Carlisle and is indistinguishable from other properties in the area. A staircase provides access between the floors. There is a private and enclosed garden area to the rear of the building and car parking to the front. The current scale for charging is £1,181.27p. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced key inspection to the home. The first visit to the home was over a short period in the morning. The second visit included the afternoon periods when the registered manager was on duty in the home. During both visits to the home I was able to meet residents and meet and talk with staff. A tour of the premises both inside and out was undertaken. Staff, resident’s records and administration files were assessed. The registered manager had completed a pre-inspection questionnaire prior to this visit. This assisted in verifying information throughout the inspection. What the service does well: What has improved since the last inspection? There is much wear and tear to the interior of the home on an ongoing basis. There has been much work undertaken and completed on the bathing and toilet areas. Areas of the home have been identified for further attention so that the living environment for people in the home is kept to standard. These matters are detailed in the Environment section of this report. The requirements made at the previous inspection have not been fully implemented and the timescales have been changed to allow for the full completion of this work. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 6 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. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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, 2, 3, 4 and 5 Quality in this outcome area was good. This judgment has been made using available evidence, including a visit to the home, meeting the manager and staff and viewing related documentation and records. The home has good procedures and documentation in place to ensure appropriate referrals and they admit people to the home whose needs they can meet. EVIDENCE: There is a Statement of Purpose and Service User Guide available as well as other information about the home’s provision of services and care. These documents are progressively being reviewed and updated to make them more accessible guides. Prospective service users can visit the home prior to admission to the home, as can relatives and or representatives, allowing people the opportunity to make an informed decision. Part of this process is to take into account the needs of people already living in the home. Comprehensive assessments are undertaken for service users. This information is used to make sure people’s care needs are clearly identified and informs the care planning system used in the home. Each resident has an individual contract of terms and conditions of residency. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 the following standard(s): 6, 7, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home, meeting with the registered manager and viewing individual care plans and related documentation. The manager and staff work very hard to encourage and support people’s individual lifestyles and ambitions. Risk assessments are well managed and a balance achieved between supporting independence and ensuring individual safety. EVIDENCE: There are individual care plans for people and much work and attention has been undertaken on these. This continues and the manager and staff are looking at ways to further strengthen the records to show the achievements of outcomes for people. There was also evidence to clearly indicate that staff are constantly seeking ways to further enhance people’s lives through better communication, enlisting other professional personnel for advice and training. This is very good practice. The manager and staff are very well informed of people’s needs. The care records are kept up-to-date and are informed by the use of daily records and regular staff meetings. People’s personal information is confidentially stored. Risk assessments and management strategies are in place and work continues to integrate these more into the care planning system. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. People’s rights are very much promoted and their individuality respected. Mealtimes are catered for on an individual basis taking choice and balance into account. EVIDENCE: People’s leisure and community involvement is detailed in their records and staff are supportive in people attending these. The manager and staff attended to these in a manner that respected people’s individuality and planned people’s inclusion with this in mind. Staff who met with me displayed a great interest and enthusiasm in encouraging people to have meaningful and enjoyable experiences. Seeking opportunities to further people’s choice and participation in everyday events. Family members are encouraged to have and maintain contact. Mealtimes are arranged to meet individual need that includes a healthy balance. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgment has been made using available evidence including a visit to the home, assessing individual records and medicines management. Health care issues are well managed and medicines are securely stored and handled by staff that are trained to do so. EVIDENCE: The manager and staff are informed of people’s healthcare need and these are clearly recorded. The staff team work positively with local health care professionals to offer an attentive and supportive approach to ensure people’s health needs are met and planned for. The manager and staff are pursuing regular appointments, for matters such as dental care so that a more proactive plan can be arranged. There is access to specialist advice and guidance and staff are very active in pursuing this. As indicated earlier in this report there are staff that work diligently in promoting positive outcomes for people and are assessing the way they record this so that their monitoring accurately reflects their practices. There are policies and procedures for medicines management and staff were informed of these. All medicines were securely stored and medication records appropriately kept. The manager and deputy manager had regularly monitored these systems. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home’s system for managing service user’s finances is sound. The home’s complaints system is available to both service users and their family and arrangements for vulnerable adult procedures are well managed. EVIDENCE: There is a complaints procedure in place and staff fully informed of this. Adult protection matters are an integral part of the staff training programme and arrangements in place to keep up to date with this. These procedures are known to staff and family members but would not necessarily be directly initiated by service users themselves. The home are seeking additional skills and training in personal communication and levels of understanding with residents. Together with using photographs and symbols the aim is to enhance people’s choice, knowledge and appropriate involvement in the decision’s made about their lives, safety and welfare. This would lead to information designed for residents in a manner that is much more user-friendly. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 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 the following standard(s): 24, 25, 26,27 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. This home experiences much wear and tear on an ongoing basis. Once the physical work is completed and systems put in place to repair and upgrade expediently it will provide a comfortable pleasant environment. EVIDENCE: Requirements were made regarding the environment at the previous inspection and these have not been fully implemented. These requirements have been repeated and a revised time-scale given for completion of the work. Since the last inspection the bathrooms and toilets have been upgraded and en-suite facilities completed for one service user. Arrangements to make access to this restricted to other people are under review by the manager. The dining room still looks somewhat bare and clinical although the new dining room table is awaiting delivery. The kitchen tiles and ceiling are marked and stained although I understand this is due for refurbishment in the future. However, the tiles do need attention now, as does the ceiling for health and safety reasons. The furnishings in two people’s bedroom need to be replaced so that there is appropriate storage for clothing. There was a requirement made at the previous inspection regarding one bedroom. The second downstairs lounge carpet is stained and the furnishings are worn. The mirror in the main lounge 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 14 has a surface that is now opaque and is of little or no value as a mirror. The swing in the garden area, used by service users, is rusty and the wooden seat rough and worn. Requirements have been made about these matters. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 15 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): 32, 34, and 35 Quality in this outcome area is good. This judgement area has been made using available evidence including a visit to the service, meeting the registering managed and staff. There had been some difficulty in recruiting staff to replace ongoing vacancies. Recent recruitment has attended to this and there are staff that remain motivated and committed to meeting the comprehensive needs of residents. EVIDENCE: Staff are provided with a good training and development programme and the manager and senior staff are pursuing additional training issues so that they can enhance the lives of people in the home. Despite the changes in the staff group the home has 50 of staff that have NVQ qualifications. The manager and staff I met during the inspection are well informed of the needs of people and certainly have great commitment to placing their needs first and provide them with life enhancing experiences. New staff to the home had had a clear induction period into the home and they are appropriately supervised during this. Their training needs are identified they are supported and encouraged in their work. There was an enthusiasm present in this staff group that is encouraging and they showed imaginative ways to further include service users in the decision making process. Looking at ways to make information user-friendly and more accessible is an ongoing process for them but these are all examples of good care practices. The home follows the recruitment procedures of Community Integrated Care. Staff had all the appropriate 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 16 checks and references completed prior to taking up their post and all appointments are subject to a probationary period. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 17 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): 37, 39, 41 and 42 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to the home, meeting the manager and staff and assessing the home records and documentation. People benefit from a service that places their personal need first and where they are valued as individuals. EVIDENCE: Although there areas that require attention to the living accommodation of Norfolk Road the registered manager has good systems in place that do see to the personal needs of service users. The registered manager, her deputy and staff are focussed on meeting the needs of people and to seeking ways to enhance their lives. Community Integrated Care monitor the delivery of service and their operations manager carries out quality assurance checks on regular unannounced visits to the home. The Commission for Social Care Inspection is notified of the outcome of these visits. The registered manager also informs the Commission of important events that happen in the home. General health and safety matters are attended to with the exception of those matters already referred to. The records examined on the day of the inspection were well ordered and up-to-date. 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 18 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 Standard No Score 1 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 2 ENVIRONMENT Standard No Score 24 2 25 2 26 2 27 3 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 X 3 X 3 X 3 2 X 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 19 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. 2. Standard YA24 YA26 Regulation 24.1 26.2 Requirement Upgrade the utility room to health and safety standards. Ensure that the clothes storage in two service users’ bedrooms is appropriate to meet their needs. Replace the mirror in the main lounge. Ensure that the kitchen tiles and ceiling are free of mould and marks. Ensure that the garden swing is safe to use. Replace the carpet and upgrade the seating arrangements in the second lounge. Make the dining room a more homely environment. Timescale for action 01/09/06 01/09/06 3 YA28 24.1 01/10/06 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 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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 14 Norfolk Road DS0000022573.V289380.R01.S.doc Version 5.1 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!