Inspection on 04/07/05 for 16 Vista Road

This inspection was carried out on 4th July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

16 Vista Road 19/05/07

16 Vista Road 09/11/05

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 Bernadette Little Unannounced 4th July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Vista Road (16) Address 16 Vista Road, Wickford, Essex SS118EJ Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01268 767210 01268 767210 Estuary Housing Association Mr S J Pledger Care Home 3 Category(ies) of PC Care Home only. 3 places in total registration, with number of places Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Personal care to be offered to no more than three Younger Adults with a learning disability. Accommodation and personal care to be provided for one named service user who is diagnosed with Alzheimers disease. (3 places in total). Date of last inspection 15/02/05 Brief Description of the Service: The home provides 24 hour residential care accommodation for up to three adults with a learning disability and one current named resident who has dementia. The home is situated close to the towns of Basildon and Wickford. The homes facilities include a large lounge/games area, a dining room, one bathroom/toilet on the first floor, one shower/toilet facility on the ground floor, three single bedrooms, an office and 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. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a routine unannounced inspection that took place on a Monday morning. It started at 9.35am and finished at 2.55pm. Time was spent sitting chatting to the three residents and four staff on duty during the inspection, and looking at the ordinary things that happened in the home. Records and other documents were inspected and all rooms in the home were seen. The help given by the staff and residents was appreciated. What the service does well: What has improved since the last inspection? What they could do better: Some of the records that the home must keep needed to have more information, especially those to help to keep residents safe. There needs to be more activities for residents at weekends. Some rooms in the home needed repainting, there needed to be plenty of hot water to the bathrooms and safety checks needed to be done regularly. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 6 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. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 5 The information available about the home offered a good range of detail to anyone interested in a place at Vista Road, with the exception of recent changes. Information on the terms and conditions was in different places but the residents’ version was easy to understand. EVIDENCE: The statement of purpose and service user guide available had not been updated to confirm the managers registration and reflect the change in the homes registration to include dementia for a specific resident. The documents were otherwise easy to read and informative. No new residents have come to live at Vista Road since the last inspection. The homes policies and procedures confirmed that a full and detailed assessment would be undertaken before any prospective resident came to live at Vista Road. Each resident’s file had a basic contract in pictorial format. It referrred to other documents but not all of these were readily available. The one service user contract sampled was not signed or dated by either the homes manager or by the residents representative. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 9, 10 The care management documentation generally provided good detail to assist staff to provide consistent and safe care for residents. Residents were supported to take appropriate risks and their confidentiality was respected. EVIDENCE: Care plans were well organised, relevant to the resident’s changing needs and provided staff with clear instruction on how to meet each area of assessed needs. Individual additional issues, such as the need for antibiotics, were again noted not to have been included. The care plan had not been updated where a resident’s medication had been changed to liquid form in their best interests. Care plans were supported by detailed risk assessments. Staff were aware of areas where residents’ rights were infringed. These were recorded, with the exception of keeping a resident indoors when distressed and they would prefer to be in the garden. Records were securely stored. Staff spoken with were aware of the homes confidentiality policy and confirmed that they would not share information about residents with anybody outside the home unless appropriate. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 17 Taking residents’ complex needs into account, Vista Road provided them with some opportunities for activities at home and in the community during the week, but this was limited at weekends. Residents were supported to maintain relationships. The food provided was varied and respected residents preferences. EVIDENCE: Two residents had access to day-care facilities. Staff advised that due to residents’ needs, they would be unable to take up employment or attend adult education classes. Residents had a programme of daily activities that also included shopping or ceramics classes, as well as routine tasks at home. Staff advised that residents would be unable to cope with using facilities such as the local hairdresser. Leisure activities at weekends were mainly restricted to drives and going to the country park. There was no formal planned menu at Vista Road. Care staff said they did the shopping and cooking based on what they knew of residents’ likes and dislikes. A nutrition record was maintained. Adequate food stocks were available. A resident confirmed that they enjoyed their breakfast. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19, 21 Residents health care and personal care needs were met at Vista Road. Policy and procedure indicated that appropriate action would be taken to ensure sensitive practice at the end of life, but residents could benefit from individually documented plans. EVIDENCE: Staff were heard and seen to guide and support residents in relation to personal hygiene. Privacy and dignity were respected. Personal care was provided by a same sex member of staff. Staff spoken with were sensitive to ensuring that personal care was provided for residents by a familiar person. Discussion with staff, inspection of the records and observation of practice demonstrated that residents have choice in the time they go to bed, get up and in the clothes they wear each day. Records inspected showed that specialist support and advice was accessed for service uses were necessary, for example from the occupational therapist or behavioural therapist. Staff confirmed that the premises and equipment met the residents’ current needs but that this needs to be monitored. A staff member spoken to advised that staff and residents had attended another residents funeral. All care plans did not indicate that residents’, or an advocates, view had been sought on the issue of terminal care and death. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22, 23 The complaints procedure was available in a format that supported resident understanding. Policies and procedures related to protecting residents were known and available to staff. Staff knowledge of appropriate actions to take if they had concern about a resident was appropriate. EVIDENCE: Each resident had a copy of the complaints procedure on their file and a copy was displayed at the office. This was in pictorial format to be easier to understand. A recent complaint from a neighbour about noise had been appropriately recorded and actioned. All but the recently employed members of staff had attended training on the protection of vulnerable adults. Records indicated that the majority of agency staff had also received this training. Staff were aware of the homes policy and procedure on this matter and also on the whistleblowing policy. This was not written in plain language. A policy and procedure on physical intervention was also available. Staff advised that residents show some challenging behaviour, for example throwing things, spitting and screaming. Estuary have previously advised that based on risk assessment, staff at this home do not require training on management of challenging behaviour. Staff spoke with demonstrated awareness that the behaviours were not personal and were usually based on frustration. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 27, 28, 29, 30 The home generally met residents’ needs but would benefit from some redecoration. Facilities need to be monitored to ensure they continue to meet the changing needs of residents. Some infection control procedures and the siting of the laundry facilities did not best protect residents. EVIDENCE: Vista Road was generally well maintained and was comfortably furnished. Some areas needed repainting and some carpets were stained. Residents’ bedrooms were personalised. Staff reported that, while the upstairs bathroom was manageable for a resident currently, space to support them was limited in this room. The stairs was also becoming a difficulty for a resident. Risk assessment and staff support was in place. There was a restricted hot water supply in the upstairs bathroom. A staff member confirmed that this was an ongoing issue. Staff explained that wet and soiled laundry was put into sealed red bags in the shower room and these were then put directly into the washing machine in the kitchen. The sluice cycle was used and linen washed at a temperature of 40°, which is not hot enough. Staff were supplied with, and wore, appropriate protective clothing and appropriate facilities were available for disposal. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 Staffing levels were appropriate to meet resident need. Estuary generally provided opportunities for training that protected both staff and residents. Areas of the home’s recruitment procedure and record keeping did not best protect residents. EVIDENCE: Staff advised of a supportive team that worked well together and of benefits for residents following the recent employment of two permanent staff. The roster needed to include the full name of all staff. Recent staff recruitment records available showed that a reference had not been taken up where the person had recently worked in a care home. No records were available for another new member of staff who had been part of the care roster for at least five weeks. Copies of Criminal Records Bureau checks, and not the originals as required, were available. A detailed induction record had been completed for a member of staff in post for some time. An induction record was not available for another member of staff who had been in post for approximately 5 months. Training records were organised and a training plan was available for each staff member. Files contained certificates that showed that staff attended mandatory training and updates, as well as training on issues specific to resident need. However, there was no certificates or records that staff had had medication training. Two staff were undertaking NVQ level 3 training. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 15 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 40, 41, 42 Vista Road presented as efficiently managed. Policies and procedures and most records sampled were of a standard that safeguarded residents and staff. Improved regularity of some routine health and safety checks and those relating to resident finance/possessions would better support this. EVIDENCE: Staff spoken with said that the manager is supportive and approachable. The corporate policy folder was known by the staff in charge of the home. Staff were aware of the revised procedure in relation to the use of residents money. Access was not available to residents’ bank account records for audit. Records available demonstrated that residents were being charged an equal amount for toiletries that they did not use equal amounts of. The list of residents’ possessions did not include all items, for example electrical items. Safety inspection certificates sampled were current. Water temperature checks and those relating to fire safety had not been undertaken regularly. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 x x 2 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 2 3 x 2 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 2 1 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Vista Road (16) Score 3 3 x 2 Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 2 2 x I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 17 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 1 Regulation 4&5 Requirement The statement of purpose and service user guide must be updated following review of the service user contracts, and to include all information required by regulation (previous timescale of 01/05/05 not met). The resident contract to be reviewed to be specific as to what services and facilities are to be provided within the fees paid and what additional charges are to be paid by residents. (Previous timescale of 01/04/05 not met). Contracts to be signed and dated. Each residents care plan must be updated to reflect their changing needs as they occur. (Previous timescale of 15/02/2005 not met). A record must be kept of any limitations agreed with the resident. The person registered must ensure that all residents have a varied range of social and recreational activities and pursuits, including at weekends. (Previous timescale of 27.11.03 not met). Timescale for action 01 August 2005 2. 5 5 01 August 2005 3. 3 6 01 August 2005 4. 5. 9 14 17 (1) (a) Schedule 3 16 (2) m &n 01 August 2005 01 August 2005 Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 18 6. 23 13 (6) 7. 24 23 (2) (d) 8. 27 23 (2) (j) 9. 30 13 (3) 10. 11. 33 34 17(2) 19 12. 34 17(2) 13. 35 18(1)(c) (i) 14. 41 20(1) and Schedule 4 (8) The person registered must ensure that all staff are provided with training on the protection of vulnerable adults. The person registered must ensure that all parts of the care home are kept reasonably decorated. The person registered must ensure that there is an adequate supply of hot water to the upstairs bathroom. The person registered must ensure appropriate infection control procedures. This refers to the siting of the washing machine in the kitchen (previous timescale of 27.11.03 not met) and the temperature at which soiled linen is washed. The roster must contain the full name of all persons employed at the care home. The person registered must evidence that robust recruitment procedures are undertaken for all staff employed at the home. This refers to the appropriate references required by the amendments to the Schedule and the original copies of Criminal Record Bureau checks The person registered must maintain in the care home all records relating to staff, including the agency staff, as specified in Schedule 4 (previous timescale of 27.11.03 not met). The person registered must ensure that all staff are provided with training appropriate to the work they are to perform. This refers to induction training. Records must be available for inspection relating to any monies or accounts held on behalf of residents. 01 August 2005 01 August 2005 01 August 2005 01 August 2005 01 August 2005 01 August 2005 01 August 2005 01 August 2005 01 August 2005 Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 19 15. 42 13(4) (a) 16. 42 23(4)(c) (v) The person registered must ensure that all part of the home are kept free from hazards as far as practical. This refers to regular checks of the water temperatures. The person registered must ensure that regular checks are undertaken of the fire equipment. 01 August 2005 01 August 2005 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. 5. 6. 7. Refer to Standard 21 23 24 32 35 37 41 Good Practice Recommendations Care plans should identify residents wishes in relation to end of life care. The whistleblowing policy should be written in plainer language. The home should have a program of planned maintenance and redecoration. A minimum of 50 of care staff should achieve NVQ training. Certificates relating to medication training should be available on each staff members file. The manager should achieve NVQ level 4 in Care and Management, {Registered Managers Award}. The list of residents possessions should include all items, for example clock radios, cassette players and tapes. Vista Road (16) I56-I06 S18028 Vista Road V236213 040705 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection South Essex Local Office Kingswood House Baxter Avenue 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. 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