Inspection on 21/04/05 for 18 Harrow Street

This inspection was carried out on 21st April 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

18 Harrow Street 28/07/06

18 Harrow Street 06/09/05

18 Harrow Street 22/09/04

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 18 Harrow Street 18 Harrow Street Grantham Lincolnshire NG31 6HF Lead Inspector Mick Walklin Unannounced 21 April 2005 10:30 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. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 18 Harrow Street Address 18 Harrow Street Grantham Lincolnshire NG31 6HF 01476 574429 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) Heritage Care Limited Mrs Janet Chadwick Care Home 5 Category(ies) of LD Learning Disability (5) registration, with number of places 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1) Service Users must only be admitted on the basis that the placing Social Worker has agreed that the room size is adequate to meet the individual`s assessed needs. 2) The Company must provide the Commission with an action plan by September 2004, stating what action they intend to take regarding bedroom sizes and facilities. Date of last inspection 22 September 2004 Brief Description of the Service: 18 Harrow Street is a bungalow situated at the end of a cul-de-sac in Grantham. It is within half a mile of the town centre, and its amenities. The home is of single storey construction, and is accessible to wheelchair users. There are lawned gardens to one side, and a patio area to the other. The home is part of the Heritage Care organisation, who also provide support to service users in three neighbouring bungalows. The home provides respite care and short breaks for up to 5 service users over the age of 18, living primarily in the Grantham and Sleaford areas. The facility is used by approximately 40 service users. All referrals are via Social Services. Service users from Grantham continue to attend their usual day service, but those from out of area have inhouse activities planned. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a seven-hour period. A tour of the building was conducted, and care records and other documents were inspected. Two staff, four people using the service, and the manager were interviewed. What the service does well: 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 6 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 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 7 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, 3, 4 & 5. There are thorough procedures for the introduction and assessment of people to the service, ensuring that their care needs are met. EVIDENCE: Heritage Care produce a ‘service user guide’, which is written in plain English, and is illustrated throughout. This contains information about the home and the services available, but this has not been circulated to people using the service, or their carers. The home’s statement of purpose has been revised to include information about arrangements for respecting privacy and dignity. One person was currently being introduced to the service, and their file contained pre-admission assessments and Social Services care plans. Records were seen of three introductory visits undertaken prior to an overnight stay, to familiarise them with the service. Unplanned emergency admissions are accepted in some circumstances. One service user had been resident at the home for over 8 months, despite the stated aim of the home to only offer respite care. However, he had recently moved to more appropriate accommodation. All service users have a contract of occupancy, which gives information about charges, and what services the home provides. A ‘service user charter’ is also available to residents in plain English, Braille and audio formats. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 8 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, 9 & 10. Care plans contain sufficient information to ensure that the care needs of service users are met during their stay, but risk assessments did not fully reflect support needs. Confidential records were not stored securely on the day of the inspection. EVIDENCE: Four service user files were inspected, and all had been updated and re-written since the last inspection, providing clear information for staff relating to the care needs of service users. Each file contained a Social Services care plan, and a care plan relating to respite care stays. All files contained a letter from relatives, stating that they had read and agreed the care plan. Although risk assessments were seen on service user files, some did not fully reflect the risks identified in the care plans. For example, one service user with epilepsy did not have a risk assessment covering supervision needs for bathing or working in the kitchen. Confidential service user files, and other documentation are stored in the boiler room. Although the door is lockable, it was left unlocked throughout the day of the inspection, so records were not securely stored. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 9 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) 12, 13, 14, 15, 16 & 17. There are a wide range of activities are available for service users to participate in, ensuring that they have an enjoyable and stimulating stay. Catering arrangements reflect service users preferences and choices. EVIDENCE: All people using the service at the time of the inspection said that there were activities and outings planned each day, and that they did not get bored. Each file contains a list of activities undertaken. All said that they enjoy their stays, and one commented “the best thing about staying is that we can chose to do what we want”. All said that they helped around the house, for example, with cleaning and meals. A computer is due to be installed shortly, and the home has a stock of games and puzzles. Three of the bedrooms are equipped with TV’s. The home does not have its own transport at present, but the manager confirmed that they were due to take delivery of a vehicle shortly. Because of the proximity to the town centre, it is easy to access facilities, and staff use their own cars or taxis for outings further afield. Service users whose usual day placement, school or college is in Grantham continue to access this during their 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 10 stays. Service users confirmed that they were able to maintain contact with relatives by telephone if they wished. Catering arrangements are of a domestic nature, and service users stated that they enjoyed the food, and confirmed that personal likes and dislikes are catered for. A list of likes, dislikes and special dietary requirements is available for staff reference to ensure that needs are met. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 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 & 20. The health needs of service users are met, with good liaison with healthcare services. Medication storage and administration systems are satisfactory, ensuring that prescribed medication is administered safely. EVIDENCE: People using the service from Grantham maintain their existing GP arrangements, and those from out of area are registered as visitors, to ensure that their health needs are met. If people become ill during their stays, their relatives would be contacted if possible, to ascertain their wishes. If appointments are booked during the stay, such as dentists or chiropody, the home will ensure that these are kept. Since the last inspection, policies and procedures have been developed, covering the receipt of medication in respite care settings, and the administration of over the counter medication, enabling staff to practice in a safer manner. All staff have received training in the administration of medication. The medication records also contain a medication information sheet, which explains to staff what the medication is for. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 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. There are robust procedures for handling complaints and allegations of adult abuse, and staff were clear on the action to take in the event of this occurring, ensuring that service users are safe. EVIDENCE: There is clear information for service users and their relatives about how to make a complaint, which is displayed in the entrance hallway. There is a clear flow chart, together with information about how to make comments, suggestions or complaints, which is in pictorial form. Heritage Care also produce a complaints leaflet with a pre-paid reply letter. There have been no complaints since the last inspection, and one compliment has been received. A copy of the Lincolnshire Adult Protection Committee procedures have now been obtained, enabling staff to follow the correct local procedures. These are cross-referenced with the home’s policy, and staff were able to describe how they would respond to allegations made by service users, in order to keep them safe. Service users said that they felt safe when staying at the home. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 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, 29 & 30. The standards of decoration and furnishing are good, providing service users with a comfortable and homely place to stay. There is a range of equipment to ensure that the needs of people with a physical disability can be met. EVIDENCE: The home is brightly decorated, and there are further plans to decorate the living room, toilet and bathroom, and to change the layout of the garden to improve the patio area. All furnishings are of a good standard, with lightweight bedroom furnishings that can be easily moved to accommodate personal preferences with the room layout. Bedrooms measure under 8.5 square metres, but service users confirmed that they liked the rooms and that there was enough space. They are offered choice as to which room they stay in as far as possible. One said that she “likes staying in the room with the picture of the parrot”, and this can usually be arranged. Three rooms are equipped with televisions, and two are equipped with light projectors to create a relaxing environment. People with a physical disability can be accommodated, and equipment such as an Arjo bath, portable and fixed hoists, and hi-lo beds or beds with cot sides are installed to ensure that their needs are met. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 14 The home was clean, with care staff being responsible for the day-to-day cleaning, with the help of service users according to their abilities. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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, 35 & 36. There is a stable staff group, with no staff vacancies at present. There are sufficient staff to meet the needs of service users, and there is a good staff training programme to enable them to carry out their role effectively. EVIDENCE: Service users said that the staff were nice and very helpful. The home is now staffed completely independently from the neighbouring bungalows, and staff said that there were enough staff to meet service users needs. Staffing levels are flexible depending on the number of people staying, and their needs. A member of staff is designated to co-ordinate training undertaken. Training records were detailed and well organised, and identified when updates were due. Heritage Care have changed the way that mandatory training has been organised, and fire training and moving and handling training were overdue. It is recommended that staff receive updates annually to safeguard service users. Staff also highlighted a problem that courses held in Grantham were often oversubscribed. Six staff have either achieved or are studying towards NVQ level 2. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 16 Staff said that they are well supported by the manager, who is open and accessible. They confirmed that they receive formal supervision at regular intervals. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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, 39, 40, 41 & 42 The home is well run, with good leadership and guidance for staff. Record keeping is of a high standard, and the health, safety and welfare of service users is promoted. EVIDENCE: The registered manager holds a nursing qualification, but has not attained NVQ level 4 in management, or an equivalent qualification. Communication is good, with monthly staff meetings. Staff said that teamwork and morale was “great”, which creates a pleasant environment for service users. The Care Services Manager has confirmed that Heritage Care will be conducting a quality assurance questionnaire in May, when the views of service users and their relatives will be sought. He also visits the home regularly to carry out unannounced checks. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 18 There are detailed policies and procedures, which ensure that service users interests are safeguarded. Only two of the staff group have been employed since 2002, and their records contained all the documents necessary for the protection of service users. However, the records of staff who transferred from Mulberry NHS Trust have been archived. Maintenance and servicing records were well organised, but the following issues, which were outstanding from the previous inspection, were identified, which could potentially put service users at risk: • • There was no safety certificate for the fixed electrical wiring, although a gas safety certificate has been obtained since the last inspection. It is acknowledged that it is the responsibility of the landlord to obtain this. Some portable electrical appliance testing had been conducted by the landlord, but this had only been for the white electrical goods, and not for other goods such as TV’s. The use of circuit breakers for electrical equipment brought in by service users was discussed. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 19 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 x 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 18 Harrow Street Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 2 x C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 20 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 YA1 Regulation 5 Requirement The registered person must ensure that the service user guide contains the information outlined in this standard and regulation, and a copy given to each service user. The registered person must arrange for the health and safety issues identified to be rectified. (Previous timescale of 31/12/04 not met.) Timescale for action 31/8/05 2. YA42 13(4) 31/8/05 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. Refer to Standard YA9 YA10 YA37 Good Practice Recommendations It is recommended that there is a direct link between risk assessments and the needs identified in the care plan. It is recommended that the boiler room be locked at all times when not in use. It is recommended that the registered manager undertake NVQ level 4 in management, or equivalent training. 18 Harrow Street C53-C04 S34259 18HarrowStreet V221762 210405 Stage 2.doc Version 1.20 Page 21 Commission for Social Care Inspection Unity House, The Point Weaver Road off Whisby Road Lincoln, LN6 3QN 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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