Inspection on 08/11/06 for 155-157 Upperton Road

This inspection was carried out on 8th November 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

155-157 Upperton Road 11/11/08

155-157 Upperton Road 19/01/06

155-157 Upperton Road 18/07/05

155-157 Upperton Road 11/01/05

155-157 Upperton Road 02/07/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 155-157 Upperton Road Leicester Leicestershire LE3 0HF Lead Inspector Keith Charlton Unannounced Inspection 8 November 2006 02:30 th 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 155-157 Upperton Road Address Leicester Leicestershire LE3 0HF 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) 0116 2547706 0116 2547706 www.mencap.org.uk Royal Mencap Society Mrs Sharon Mary Brealey Care Home 8 Category(ies) of Learning disability (8) registration, with number of places 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No Additional Conditions of Registration. Date of last inspection 19/1/06 Brief Description of the Service: The home is located in two connected terraced houses in a popular residential area in Leicester. The property is pleasantly decorated throughout and service users rooms are extensively personalised with belongings and décor. The home can accommodate up to eight service users with a learning disability. Service users benefit from easy access to a range of local facilities such as parks, pubs and shops. Fees are typically £340 per week – this information was provided before the day of the inspection. There are costs for extras – hairdressing, toiletries, holidays, chiropody etc. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service user and their views of the service provided… The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Manager was on duty to assist with the inspection process. Other support staff also assisted. Planning for the Inspection included looking at the last Inspection Report and assessing any notifications of significant events sent to the Commission for Social Care Inspection by the home. There have been no complaints received regarding the home in the past year. The Inspections took place between 14.15 and 18.30 on day one and completed the following day, and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with five residents, two members of staff, one relative and the Registered Manager. What the service does well: Residents have very comprehensive, useful and up to date assessments of their needs. This ensures that the care receive is tailor made to meet their requirements. The service focuses on residents’ individual needs, e.g. residents spoken with said they liked living in the home and thought staff were friendly, the food was good and they liked their bedrooms. Care Plans are comprehensive and detailed to assist staff to deliver care that fits individual service users care needs. A choice of foods is always available to service users and there is an emphasis on healthy eating. Pictures are used for residents’ information – Quality Assurance Surveys, the Statement of Purpose that describes the services offered, the Complaints Procedure, menus etc., to make it easier for residents to understand this information. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 6 Staff were found to be positive, friendly and helpful in their dealings with residents. Bedrooms are personalised and homely and organised to residents’ styles of living with a large amount of possessions in them to make them homely. Facilities are kept in a generally clean and tidy condition and decor is kept to a good standard. The Registered Manager arranges residents meetings to provide information about services and asks their views about them. The minutes kept are detailed and clear. The Registered Manager continues to be proactive in planning for staff training and asking for suggestions on how to improve the service. Detailed staff meeting and staff supervision notes continue to be kept to alert staff to care needs and consistently good staff practice. What has improved since the last inspection? What they could do better: Setting up a staff training matrix would quickly supply information as to whether staff need any essential training to help provide more effective care to service users. Health and Safety systems need to be followed up to ensure that service users are protected from burning from unprotected radiators. Some radiators were not working. (Both issues have been reported to the landlord). Facilities could be improved with redecoration of landing and corridor areas and one resident’s bedroom, replacement of a carpet to a resident’s bedroom as it was worn and stained, (which was acknowledged by the Registered Manager). It is strongly recommended that this be replaced to improve the homeliness of this facility. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 7 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. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 8 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 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 9 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment system to meet residents needs is in place. EVIDENCE: A resident said that he stayed in the home for a two day trial before he made up his mind about coming to live there. The Registered Manager said that a trial period is available for residents to sample living at the home before becoming confirming a permanent stay. Evidence seen by the inspector showed that there are social work assessments prior to the admission of residents. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The individual needs and choices of people living in the home are well met. EVIDENCE: Residents spoken with thought they were well looked after and no one thought they were restricted in any way. The inspector case tracked two care records, which again clearly demonstrated that service users changing needs are being monitored and supported whilst living at the home. Records, observations and discussions with service users demonstrate that they make decisions about their lives and have independent life styles as much as possible, e.g. some residents are able to go out on their own, residents are encouraged to do household chores, do as much of their personal care as possible and they can use the kitchen with staff supervision and take it in turns to help with cooking. Staff said service users can make decisions about their own lives wherever possible e.g. what time to get up and go to bed, where they want to go on 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 11 holiday, when they want to bathe, etc. They are asked their views on important issues in their meetings and these are recorded regarding food, holidays, outings etc. Staff said that residents independence is always encouraged, as it is an essential part of the philosophy of the home. Residents having to do domestic chores is part of the ‘House Rules’, which staff said residents understand before admission. No residents objected to doing their chores. It is recommended that residents have representation in staff meetings and for staff interviews, if they wish, so as to increase their voice as to the running of the service. Two residents’ care plans were viewed within individual record files. Both files contained detailed and comprehensive information with actions stated as to how staff were expected to meet those identified needs. Evidence was seen of a range of risk assessments, which addressed activities chosen by residents that may present risk. These included safety in the community. Risk assessments identified aspects of each resident’s care needs that resulted in increased vulnerability. This is good practice. Staff spoken with were knowledgeable about the care and support each service user required. Staff were observed offering choices to service users, e.g. choice of food for tea. It is recommended that residents life histories be recorded, subject to obtaining the resident’s permission to do this, so that all relevant issues relating to the resident can be fully appreciated by staff. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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): 12,13,15,17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents living at the home have the opportunity to have a fulfilling lifestyle. EVIDENCE: 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 13 Residents spoken to said they could do what they wanted to do and that they liked going out. Staff said one resident had ‘retired’, i.e. he did not want to do set day activities, and this choice was respected by staff. Another resident said he had recently been on two holidays this year, to Devon and Bruges, which he really enjoyed. The evening of the inspection people who wanted to go were going to the Gateway club, which they said they liked doing. There was evidence of activities –music, cooking, going out to activities – colleges, discos, local pubs etc. Records showed that residents have been on trips and are asked where they want to go on holiday. Residents Meeting notes showed that they have been consulted and trips are planned in the future. Staff said that residents use a range of community facilities including local shops, pubs, the park, the post office to get their money as well as attending specific groups for people with learning disabilities. Residents said they could have their visitors to the home and that there were no restrictions on visiting times. A resident said he had a girlfriend and he could invite her to visit when he wanted to. A staff member said that it was important for residents to maintain contact with their friends and family. A relative visited and said that staff were always welcoming and that the care provided to his brother was always of a high standard. Food records showed that service users were given a choice of food. The tea tasted was of a good standard with a choice of food, with vegetables as part of the meal, thereby encouraging healthy eating. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good personal support with their physical and emotional health needs being well met. EVIDENCE: There is a very comprehensive information kept which details all medical appointments and check ups on an individual basis - from nurses, GPs, dentist, etc. Care Plans indicate all aspects of service users health care needs are covered – e.g. management of personal care, monitoring weight, communication, social skills, work and play etc. Accident/Incident Records were checked and it was found that staff had reacted appropriately to all situations presented. Staff stated that all staff that issue medication have been trained by the pharmacist, by Mencap and also there was a distance learning pack that staff were expected to complete. Staff training records supported this. The home 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 15 has a policy and procedure for the safe administration of medications and has a two person checking procedure to ensure medication is issued and recorded appropriately. Medication records were checked and found to be up to date. Medication is kept securely locked away. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents welfare is protected by robust procedures. Residents views are listened to and acted upon. EVIDENCE: Residents said that if they were worried about anything they would speak to staff or the Manager and they thought it would be followed up. The Registered Manager stated in the Pre Inspection Questionnaire, that was provided prior to the inspection, that there have been no complaints made by residents or relatives in the last year. The Commission for Social Care Inspection has also received no complaints regarding the service in this time. The Complaints Procedure seen by the inspector reflects the National Minimum Standard in that it stated that any complaints would be properly followed up. There are residents meetings held where all residents are invited to attend and share their views about the home. A record of these meetings is available for residents and staff to refer to. Staff members on duty were asked about their understanding of whistle blowing procedures, and both demonstrated a good understanding of the protection of residents from abuse. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 17 The home has policies and procedures, including the “No Secrets” and Protection of Vulnerable Adults documents. Training is provided on adult protection. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 18 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): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a homely and comfortable environment, and standards of hygiene are good. EVIDENCE: Residents said that they liked their bedrooms and they could have all their things in them. Some residents showed the inspector their bedrooms. Observations of the bedrooms demonstrated that décor in their bedrooms suit their lifestyles. One bedroom needed redecoration. The Registered Manager acknowledged this though said this resident liked DIY and décor would soon return to its original condition. His carpet is old and stained. The Registered Manager said it would be replaced. Communal areas looked comfortable except hallways, corridors and stairways, which looked stark. This has been noted in the Registered Manager’s improvement plan and residents are to be encouraged to do artwork to hang 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 19 on these walls. It is recommended that these areas be painted in colours of residents choosing to improve their homely feel. Standards of cleanliness and odour control in all areas of the home were good. It was noted that a number of radiators were not working. The maintenance book was checked and it was found that this had been referred to the landlord for follow up, which is quickly needed as the cold weather has now arrived. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 20 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from a dedicated staff group, with sufficient staff numbers on duty to meet residents needs. EVIDENCE: 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 21 Residents spoken to were very happy with staff and saw them as helpful and friendly. The visitor also said staff were very efficient and welcoming. Staffing levels during the course of the inspection met the relevant minimum standards. There are two care staff on duty during daytime/evening periods, and this was found to be the case by the inspector, with a sleeping staff member on duty at night with staff on call if needed. The rota needs to clearly show two staff on duty for pm periods, as this did not indicate the sleeping in staff does the pm shift. Staff records were inspected but and generally found to have all the necessary statutory checks, though identification was missing on some records. The Registered Manager said she would obtain copies of such documents to ensure they are available for inspection. Staff members were spoken to and had a good knowledge of service uses care needs and were again committed to providing a good service to residents. They are supplied with regular supervision, which is very well recorded. The Registered Manager has stated that there are approximately 30 of staff with a National Vocational Qualification level 2 qualifications. Staff spoken to said they were encouraged to undertake this training. This needs to be followed up to attain the 50 needed to attain the National Minimum Standard. Staff have had training in a wide range of topics – the Person Centred Planning system which identifies service users individual needs, Lifestyle Planning, Epilepsy, Communication, Health Action Planning, Risk Assessment, Report Writing, Fire, Food Hygiene, etc. Training records are kept within individual staff files. New staff have to go through a detailed induction programme, based on the Skills for Care professional model. It is recommended that a training matrix be set up to quickly identify who needs training in what topic. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 22 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): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from the proactive management of the home. EVIDENCE: 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 23 Both residents and staff spoke highly of how the Registered Manager runs the home. The Staff Meeting notes seen are detailed and comprehensive and focus on ensuring staff meet residents care needs. Service users have been asked as to their views on the way the home is run through a detailed Quality Assurance survey, though this was not dated. The Registered Manager needs to analyse the results of surveys, to produce an Action Plan and include this information in the Statement of Purpose. Staff members were asked as to the fire procedure and were aware of this. Fire records showed that regular testing of fire bells and emergency lighting was in place and there are regular fire drills. The fire risk assessment is in place. Some residents monies were checked and found to be in order. Records had receipts, running balances and two signatures and monies are checked daily to ensure they are correct. This situation is commended. The Registered Manager has ordered the fitting of radiator covers as assessed as needed from the landlord, though this remains outstanding since May 2006. The hot water temperature was measured and found to be within the National Minimum Standard at 39c. As the National Minimum Standard is 43c, water can be hotter than this if residents wish to have a warmer bath. There are hot water monitoring charts in place to ensure residents are protected from scalding temperatures. Health and Safety Policies and Procedures are in place and staff said they are encouraged to read them. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 24 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 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 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 4 3 4 X 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 3 3 3 X 3 X 3 X X 2 X 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 Refer to Standard YA24 YA42 Good Practice Recommendations A stained bedroom carpet needs to be kept in a clean condition. It is recommended it be replaced. Health and Safety issues regarding uncovered radiators need to be followed up and actioned. 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 155-157 Upperton Road DS0000006367.V313424.R01.S.doc Version 5.2 Page 27 - 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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