CARE HOME ADULTS 18-65
140 Gloucester Road Kidsgrove Stoke on Trent Staffordshire ST17 1EL Lead Inspector
Jane Capron Unannounced Inspection 14th November 2005 03:15 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service 140 Gloucester Road Address Kidsgrove Stoke on Trent Staffordshire ST17 1EL 01782 782596 01782 775918 linda.foden@staffordshire.gov.uk 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) Staffordshire County Council, Social Care and Health Directorate Linda Ann Foden Care Home 17 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (2), Learning disability (17), Learning disability of places over 65 years of age (6), Mental disorder, excluding learning disability or dementia (2), Physical disability (4) 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: 140 Gloucester Road is a home providing 24 hour care for 17 residents with a learning disability. A number of residents have additional needs including physical, sensory, challenging behaviour and mental health. The home is owned by Staffordshire County Council and managed by the Social Care and Health Directorate. The home is located in Kidsgrove not far from local shopping facilities. It is set back from the road in large grassed grounds. The home has two houses in the grounds for service users supported through the domiciliary services and their management is unconnected to the home. The home provides all single bedroom accommodation of which eight were downstairs. The home did not have a lift. The home had one large communal lounge and an industrial kitchen and three lounges with kitchens. The residents are divided into small groups and the groups spend time in their own lounge and eat together in their kitchen/diner. All the service users attend Kidsgrove day services. The home has recently been refurbished providing residents with a high standard of accommodation. The home has good staffing levels. The aim of the home is to promote residents to be as independent ad possible. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place during the late afternoon/ early evening and lasted approximately three hours. The inspection included assessing a number of key standards as the home had achieved most standards on the last inspection. All the areas where the home had not reached the standards were assessed. The inspection concentrated on discussions with residents and during the inspection eleven residents were spoken to. Discussions were also held with several staff and with the manager of the home. Since the last inspection no complaints had been received by the commission and there had been no additional visits. The home provided a good standard of care and promoted residents independence and treated residents with respect and dignity. The residents enjoyed a full and varied lifestyle. What the service does well:
The home was providing a good service to the residents. The residents liked living at the home. The staff had the necessary knowledge, skill and attitude to support the residents to have their needs met. The home promoted residents’ rights and treated them with respect and dignity and encouraged them to be as independent as possible. Residents were supported and encouraged to take decisions over their lives and to participate in a range of daily living tasks around the home. Residents liked the staff and found them approachable and helpful. The home supported residents to undertake a range of social and leisure activities in the community. Residents’ views were sought and listened to through individual and group meetings with staff. Contact with family and friends was supported and visitors were able to visit at any reasonable time. The home had a good care planning process that worked with the resident to identify their needs and wishes and had plans in place to show how these needs were to be met. Residents’ health and personal care needs were being met. Residents had health and medication reviews including health screening and attended for dental and eye tests. Residents benefited from good multi agency working. The residents’ individuality was respected and personal care tasks were undertaken at a time of the residents’ choosing and in the manner they wanted.
140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 6 The residents had a high standard of accommodation. The home was well decorated and furnished and well maintained. There were suitable communal areas and residents were divided into groups having their own lounge area. 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. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4 All admissions were subject to an assessment by the Assessment and Care Management team of the local authority prior to admission but it would be beneficial for the home to undertake their own assessment in order for the home to be fully clear over a prospective resident’s needs. Prospective residents were able to take part in introductory visits and were admitted on a trial basis enabling the home and the resident to be sure that they wanted to stay in the home and that the home was able to meet their needs. The residents’ needs were being met by staff with the necessary knowledge, skill and attitude and through the involvement of a range of specialist and primary health care staff. EVIDENCE: The examination of the documentation of recently admitted residents showed that the Assessment and Care Management team completed an assessment prior to any admission. These provided the information for the home to make a decision over the appropriateness of a placement. However there had been instances when a person had been admitted when it was not completely clear that the home could meet their needs. It would therefore be advisable for the home to complete their own assessment when possible prior to admission. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 9 Unless a placement was made in a urgent manner all prospective residents undertook a programme of introduction that could include visits for meals and overnight stays. All placements were made on a trial basis and only made permanent following a review of all relevant parties. The home had the necessary knowledge and skills in the specific conditions of the residents and had the necessary skills in working with people with a learning disability. The home had links with a range of specialists to support the residents and the staff in providing the necessary support and care. These included staff from the psychiatric and psychological services, speech and language therapists as well as staff from the primary care services and from the local authority day services. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 The home had very good support plans in place, however in order to ensure that staff are able to meet the needs of new residents, as well as established residents, basic support plans need be put in place as close after admission as possible. The home promoted decision making and participation providing residents with choice over their daily lives and involvement in a range of daily living tasks. The home had developed a range of individual risk assessments having plans in place to support residents to take reasonable risks and not to be subject to unnecessary restrictions. EVIDENCE: The home had developed comprehensive support plans through person centred planning. These covered all the required areas including health and personal care, educational, leisure, financial needs and any specific communication needs. Where specific plans were needed these were in place. Residents spoken to said that they were involved in developing their own plans through discussions with their key worker. They felt that staff listened to their wishes.
140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 11 The support plans were reviewed on a six monthly basis through a multi disciplinary meeting, however this review was not always evident on the elements of the support plans. The most recently admitted resident did not have any support plans in place although an assessment was present. Whilst it takes some time to put together comprehensive support plans some basic plans need to be in place in order that the staff have enough information to be able to meet a resident’s needs. Residents stated that they made a wide range of decisions over what they ate, how they spent their time, what they wore and what activities they undertook. Staff provided the necessary support for residents to go shopping and to buy personal items such as clothes, toiletries and presents. Procedures were in place to ensure that residents were safeguarded when large amounts of their money were being spent. The home accessed advocates when needed and the day services ran a self-advocacy group. Support plans identified the support residents needed to mange their money. Residents participated in a range of tasks around the home including meal preparation, cooking, laying and clearing the table, washing up and keeping their bedroom and the lounges clean and tidy. Residents’ views were sought through resident meetings and through the quality assurance scheme. The home had developed a range of individual risk assessments. These showed evidence of review. The home involved specialist staff when necessary to offer advice over risk management in specific situations. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,13,15,16 The home provided opportunities for personal development enabling residents to develop their skills and to be as independent as possible. The home provided a relaxed atmosphere where residents were supported to make choices about their daily lives and to exercise their rights over how to spend their time. Links with and access to the community were good and enhanced the residents’ quality of life. Residents were encouraged and supported to maintain and develop relationships with family and friends. EVIDENCE: The home provided opportunities for personal development. Residents undertook a range of independent living tasks and encouraged social skill development through day-to-day activities. Plans were in place to respond to special communication needs through contact with the speech and language
140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 13 therapist and through having individual communication plans when needed. Residents had the opportunity to have their Christian spiritual needs met but should there be any other spiritual needs the ability to meet these would need to be discussed prior to admission. The home promoted community presence. Residents stated that they accessed a range of community resources including shops, primary health care services, the hairdresser, and a number of leisure and social venues. Residents used taxis or public transport as the home did not have its own transport. The home supported residents to maintain contact with family and friends. Visitors were welcomed at any reasonable time and some of the residents went to stay with family members. Several residents stated that they had friends both in and out of the home and that at times friends visited them at the home. Residents stated that the home had few rules. They could get up and go to bed when they wanted. They could have their breakfast when they got up and there was always a choice at mealtimes. If they did not like any of the choices they could have something else. When in the home residents said they could spend time in their bedroom or sit in the communal areas. They were able to decide how to spend their time. They were able to choose whether to go out on trips or to remain at the home. Residents said they liked the staff and that they talked to them. Several residents had keys to their bedroom and liked being able to lock their bedrooms. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 The health care needs of the residents were well met with residents receiving specialist health care services and regular health screening. Personal support was provided in such a way that it promoted the privacy and dignity of the residents. EVIDENCE: The home had comprehensive plans in place to meet the personal and health care needs of the residents. The support plans identified any personal care support needed. The individual preferences of how residents liked tasks being done were recorded. Residents confirmed that they had key workers and that they could alter their worker if they wanted. Residents bought and chose their own clothes with staff providing any necessary support. Residents decided on what they wanted to wear and their clothes were age and weather appropriate. The home arranged for residents to have their health care needs met. Residents received regular health and medication reviews and attended for health care screening including attending well person clinics. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 15 Residents received specialist health care services when needed including psychiatric, psychological, community nurse and OT and physiotherapy support. Residents confirmed that they attended dental and eye checks and had their nail and hair care attended to. Residents with hearing needed attended for the audiology clinic. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: As the home met the standards on the last inspection these were not assessed. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 17 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,28,30 The premises were well decorated and furnished and well maintained providing residents with suitable communal and private accommodation. The home’s cleaning and hygiene procedures provided the residents with increased protection from the spread of infections. EVIDENCE: The home provided a high standard of accommodation. The home was well decorated and furnished and well maintained. Although accommodating 17 residents the home had divided residents into groups of about four that had their own kitchen, diner and lounge. The home also had a large kitchen downstairs that cooked for some residents. This enabled residents to have greater choice and greater opportunities to develop friendships and to undertake independent living activities. The home was suitably heated and ventilated. The home had suitable communal and bedrooms accommodation. The home had procedures in place for the control of infection. Cleaning schedules were in place and all staff received training in infection control. The home had supplies of gloves and aprons. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 18 The home employed domestic staff that undertook cleaning and laundry tasks. The residents with the support of the staff maintained the cleanliness of their bedrooms. The home had a laundry with washing machines that were able to wash at a temperature that would disinfect soiled linen. The laundry had a sluicing facility although this was not used on a regular basis. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 19 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,36 Residents were supported by staff who knew their role and responsibilities and who were well motivated and had the necessary skills and knowledge. Residents benefited from staff that were well supported and supervised by the senior staff to undertake their role. EVIDENCE: Staff were clear over their roles and responsibilities in supporting the residents. Staff were provided with a job description and a code of conduct. The staffing levels allowed for their to be a senior staff member to be on duty at all times during the day. Staff were observed to be well motivated and interested in the residents’ well being. Residents were observed readily approaching staff and residents stated that they liked the staff and got on well with them. They felt that the staff were kind and caring. All staff received a comprehensive induction when commencing work and undertook a range of training relevant to their role. Staff were aware of the individual needs of the residents and how these needs were to be met. The staff were aware of issues of aggression and of self harm and had plans in place to respond to any such incidents. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 20 At the time of the inspection there were 24 staff members. Five were qualified to at least NVQ level2 and a further seven were undertaking the qualification. Once completed the home will meet the target of at least 50 qualified. Staff confirmed that they received individual supervision and that the home had staff meetings approximately once a month. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 21 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None of the above standards were assessed on this inspection. 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 X Standard No 22 23 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 4 X Standard No 24 25 26 27 28 29 30
STAFFING Score 4 X X X 4 X 4 LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 4 3 X X X 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
140 Gloucester Road Score 3 4 X X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000028867.V266440.R01.S.doc Version 5.0 Page 23 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 YA6 Regulation 15(2) Requirement New residents should have basic support plans in place. (Previous timescale not met) Timescale for action 01/12/05 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. 2. 3. 4 Refer to Standard YA8 YA2 YA5 YA13 Good Practice Recommendations To develop further the participation of the residents in aspects of the running of the home For the home to undertake their own assessment to identify more clearly whether they are able to meet the needs of prospective residents. To complete the monthly reviews in respect of leisure activities and community presence. To consider the home having the use of its own transport 140 Gloucester Road DS0000028867.V266440.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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