Inspection on 19/05/07 for 16 Vista Road

This inspection was carried out on 19th May 2007.

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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

16 Vista Road 09/11/05

16 Vista Road 04/07/05

16 Vista Road 15/02/05

16 Vista Road 05/10/04

16 Vista Road 27/11/03

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Vista Road (16) 16 Vista Road Wickford Essex SS11 8EJ Lead Inspector Mrs Bernadette Little Unannounced Inspection 19th May 2007 09:20 Vista Road (16) DS0000018028.V338371.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 Vista Road (16) DS0000018028.V338371.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. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Vista Road (16) Address 16 Vista Road Wickford Essex SS11 8EJ 01268 767210 01268 767210 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) Estuary Housing Association Limited Mr Simon Jonathon Pledger Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION 344Conditions of registration: 1. No more than three (3) Younger Adults with a learning disability to be accommodated. 9th November 2005 Date of last inspection Brief Description of the Service: The home provides 24 hour residential care accommodation for up to three adults with a learning disability. The home is situated close to the towns of Basildon and Wickford. The homes facilities include a large lounge, a dining room, separate kitchen, one bathroom/toilet on the first floor, one shower/toilet facility on the ground floor, three single bedrooms and an office. There is a garden to the rear of the property. In addition the home provides some off street parking. Residents within the home access a limited range of formal and informal day care provision/activities. The home has its own vehicle to enable residents to access the local community. Information from a resident’s statement of terms and conditions indicate that weekly fees for the year 2005/06 were £2,115.89. Residents additionally pay for chiropody, their toiletries, cigarettes, personal items such as birthday gifts and also for their own bedroom furniture. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on a Saturday. The home had been informed of the inspection the evening before, as a previous attempt to undertake the inspection was not possible, as staff and residents were out in the community. The manager was on annual leave. The three staff on duty and the three residents assisted with the inspection and their help was very much appreciated. The residents at Vista Road have complex needs and comments on their views of how they find the home were not possible to get, even with the support of the staff. All parts of the premises were inspected as were a sample of records, policies and procedures. Time was spent sitting with residents and staff, observing everyday life at the home. What the service does well: What has improved since the last inspection? What they could do better: One safety concern was found and that was about an opening upstairs window, which could have been a risk to residents. A notice was left with the home that required them to make this safe without delay. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 6 Some records that show that staff are safe people to look after residents were not at the home as they should be. This included records about agency staff that Estuary need to get and give to the home’s manager. The manager and owner had been told in an inspection report some time back about things that needed to be done such as the staff records and records of the training given to new staff. It was disappointing to see they still were not right. 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. The summary of this inspection report can be made available in other formats on request. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 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 Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4, 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service People thinking of using Vista Road will have the information and opportunity to choose a home that will meet their needs, which will be assessed. EVIDENCE: It was noted from a residents file that the statement of purpose and service user guide had been updated recently. Copies now need to be sent to the commission as required. One person was staying at the home for a few days as part of a series of trial visits. This was part of their assessment process and to allow them to try out the home and slowly get used to living there. Detailed assessment forms were seen on the persons file, including information from their family and the supporting social worker. Staff files sampled showed that permanent staff had attended a range of training related to the specific conditions of the current residents, including in relation to communication, autism, Down’s syndrome and sensory impairment. A pictorial format contract was seen on one of the permanent resident’s files. This was signed and dated July 2005. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 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. 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. Residents living at Vista Road can expect to receive good care and support. Residents can be involved in making decisions about their daily lives and take risks appropriate to their abilities. EVIDENCE: A basic care plan was in place for the resident staying at the home on the trial basis. This included information on their likes and dislikes including food, their preferences for activities and routines, their behaviours, and the support needed for the different aspects of personal care. An appropriate risk assessment was also available. Care plans for permanent residents were detailed and were supported by appropriate risk assessments. These included consideration on aspects of resident’s behaviours and choices, while supporting them to act appropriately, and so protecting them. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 10 There was no evidence that, within individual abilities, residents are involved in developing and agreeing their care plans, for example using pictorial formats. Staff spoken with and observed showed that they knew the individual residents and their particular care needs and personalities. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents at Vista Road have the opportunity for personal development, are able to participate in some appropriate activities and enjoy a varied diet. EVIDENCE: One resident had access to a day-care facility twice a week. All residents attended a weekly ceramics class. One resident went on holiday last year for a week while the other had specific planned day trips. Residents go shopping with staff once a week and have a meal out at that time. Staff advised that residents are not interested in looking at books, television or videos and this was observed during the inspection. Staff said that they try to take residents out as much as possible and regularly go for walks and drives as this is what they like to do. Bowling is also reported as popular. Some of the staff and residents went out for a walk during the site visit. At other times they sat in the garden where we all had a drink together, or they spent time alone in their room or in the living room, as was their choice. One person enjoyed music and sounds. It is hoped to reintroduce opportunities for swimming. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 12 Staff advised that it was not easy to give their residents opportunities to make decisions and choices in some ways but that they were supported to do this in any way they could, usually in small things such as a choice of food and drinks, when to go to bed or get up, what and when to eat, the clothes they wore each day and whether to be alone or be with others. Residents were also encouraged to join in tasks such as vacuuming. One resident cleared away the cups and took them into the kitchen. There is no planned menu. A record is kept of what residents eat each day. A staff member explained that you would then check this record so as not to repeat food too often, and then offer residents a couple of things to choose from or ask what they want. There were clear instructions in the kitchen for a start to support residents to make choices and be involved in the preparation of their food and drinks where this is possible. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 13 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. 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 can expect to receive good personal, healthcare and emotional support based on their individual needs. Their medication will be managed safely. EVIDENCE: Staff confirmed that all residents are mobile and required no equipment or assistance. Care plans give clear instructions to help staff support residents with their personal care. Staff were clear about respecting resident privacy and dignity at this time including keeping doors shut while personal care was being offered. Residents have had limited or no contact with any relatives. Two of the residents have lived at Vista Road for several years and there were clearly established positive relationships with the staff. Residents were seen to approach staff and to make their wishes and needs known. Staff clearly knew residents, were able to understand their communications and remained aware of residents and observed their well-being. A separate file was maintained regarding resident health care. Records showed that residents’ weight was monitored regularly. Records were maintained of Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 14 contacts with the dentist, chiropodist, oral surgeon, nurse practitioner or GP. It was recommended to confirm if the appointment had occurred and record brief information on the actual outcome for example of blood tests. Medication management was identified in care plans. Residents were noted to have limited prescribed medications. The record of medications administered showed no omissions, and a sample signatory list was noted on the file of those staff deemed competent to administer medication. Medication sampled tallied with the records. Competence assessment records for the staff were also contained on the file, which is considered good practice. It was disappointing however that they had not been reassessed in the last year. Staff files sampled contained certificates for medication training within the last year. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 15 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. 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 at Vista Road have systems help them to raise concerns and have access to a clear complaints process. Residents will be protected from abuse. EVIDENCE: A pictorial complaints procedure was displayed in the office and a copy was on the permanent resident’s file as part of the service user guide. A complaints log was maintained. This contained one entry relating to a complaint from a neighbour about inconsiderate parking. It was advised that this was unintentional by a new member of staff and had been actioned to ensure respect for other members of the community. Five of six files sampled demonstrated that staff have had training in protecting vulnerable adults(pova) in the past year. Certificates for pova training indicated that they included consideration of behaviour that challenges. One of the agency staff also had a confirmed record of recent pova training. Permanent staff were aware of appropriate procedures in relation to reporting. Agency staff were clear that they would not tolerate inappropriate behaviour to residents but were not as clear on how and to whom it should be reported and advice was provided. It has been an outstanding recommendation for some time that Estuary provide staff with a whistleblowing policy that is written in plain English. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Apart from one safety concern, Vista Road is a welcoming, comfortable, clean and safe place to live. EVIDENCE: The judgement above is based on one specific health and safety risk to residents, otherwise the home was clean, nicely decorated/maintained, homely and with adequate batting/shower facilities and different communal spaces for residents to use. The garden was being well used by residents. An immediate requirement notice was issued because of the concern regarding the opening upstairs window that was not fitted with restrictors as the other windows were. This window did overlook a flat roof but still presented a risk to all the residents, not only the resident now using the room that had been vacant for some time. The permanent member of staff on duty confirmed that a safe and agreed way of managing this would be put in place over the weekend and until it could be addressed. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35, 36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by staff who are well trained and supported, and available in sufficient numbers to meet their needs. Residents are not well protected by the homes’ recruitment practices. EVIDENCE: Job descriptions were available on the files of permanent staff. Staff worked well together, with the permanent member of staff managing medication etc. Rosters sampled showed that there was always one of permanent member of staff on duty and this was confirmed by staff at the site visit. Staffing levels were also confirmed as appropriate, with two staff on duty during the day when two residents were living there, a third staff member with the third resident was living there and one awake staff at night. Recruitment files were sampled for two permanent members of staff. Both contained appropriate Criminal Records Bureau checks. One file had neither of the two required references. Applications did not contain a declaration of physical and mental health. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 18 There were no details available for the agency staff members as required, and as previously agreed by Estuary. There was no induction record on either of the two permanent staff recruitment files sampled, although the staff had been in post for some time, and no induction records for agency staff. Issues relating to the need to maintain all recruitment and induction records of had been raised in a previous inspection report. The training file was particularly well organised and well maintained. Certificates were available to confirm that most staff had had up to date basic training in fire, pova, first aid, moving and handling, health and safety, risk assessment, medication and food hygiene, with few exceptions that need to arranged. In addition to this staff had had a range of training in issues such as epilepsy, person centred planning for mental health. The permanent staff member advised that two of the seven permanent staff have achieved NVQ level 3, and that they were themselves waiting for a start date. One of the two agency staff had their record of training with them, which confirmed that they also had up-to-date training in all the basic subjects, as well as other relevant topics. The rota was very clear and colour co-ordinated. This clearly showed plan to supervision sessions for staff. Supervision records were not viewed but the permanent member of staff on duty confirms that supervision occurs regularly and the topics covered where appropriate. In addition, staff read up on current issues to discuss, for example the permanent member of staff was reading through the Mental Capacity Act. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39, 41, 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 living in a home that is well run and has clear leadership and generally good internal management. EVIDENCE: The training file for the registered manager demonstrated that they regularly attended training and kept their knowledge base updated. All staff spoken with said that the manager was approachable. The home presented as well organised, care and supervision of residents was carried out in a calm and systematic way that came across as resident lead. Safeguarding residents is an area for development in relation to the window safety and the lack of appropriate recruitment records. There was no information available on quality assurance on this occasion. Records indicated that Estuary have not undertaken their required monthly visits to the home to monitor the quality of care and the conduct of the home. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 20 Staff advised that because of their complex needs, that even with their support, residents would not be able to meaningfully complete the inspection surveys, or participate in residents’ meetings. Other than recruitment records, records sampled were generally well maintained, for example accident records, care management records, visitors book. The registration certificate and certificate of current liability insurance were displayed. It was not possible to inspect and fully audit all records relating to resident’s money. Records were available of resident’s weekly expenditure and a group rolling float. Receipts are sent Estuary each week and therefore could not be confirmed. The limited records/receipts available showed that residents purchase individual items. Those sampled indicated that residents money was being used for personal items for residents including toiletries, clothes, cigarettes etc.. Records showed that water temperatures, both hot and cold, were regularly checked. Checks of the fire alarm, emergency lighting, and fire equipment were not regularly maintained within their own timescales. A record of fire drills was not available. Irregular maintenance of these records had been raised in a previous inspection report. Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 21 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 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 1 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 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 2 3 x 3 3 2 X 3 2 x Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 22 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. 1. Standard YA24 Regulation 13(4) Requirement To protect residents from possible harm, the opening windows in the upstairs front bedroom must be made safe. To protect residents, records must show that all the checks on all staff have be done to make sure they are safe people to care for residents. Residents care outcomes and the conduct of the home generally must be checked monthly by Estuary and the record of the visit available for inspection. Residents’ safety must be protected by ensuring regular fire practices and checks of equipment. Timescale for action 19/05/07 2. YA34 17(2)Sch 4& 19 Sch 2 01/06/07 3. YA39 26 01/06/07 4. YA42 23(4) 01/06/07 Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 23 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 YA5 Good Practice Recommendations Residents should have up-to-date information n their statement of terms and conditions about the fees for their placement. To support residents’ health and well-being, records should show whether a resident has attended a planned healthcare appointment or check and what the outcome was. The homes whistle blowing policy should be written in plainer language to support staff to protect residents. All staff need to be clear on the steps that need to be taken to report any concerns they may have about the way residents are treated. 4. 5. YA32 YA35 At least 50 of the staff should achieve NVQ training. To show that staff have been supported and given training to provide quality care outcomes to residents from the beginning, completed records of staff induction training should be available and kept on the staff members’ file 2. YA19 3. YA23 Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Vista Road (16) DS0000018028.V338371.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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