Inspection on 28/07/06 for 18 Harrow Street

This inspection was carried out on 28th July 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

18 Harrow Street 06/09/05

18 Harrow Street 21/04/05

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 Inspection 28th July 2006 11:30 18 Harrow Street DS0000034259.V306002.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 18 Harrow Street DS0000034259.V306002.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. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 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 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) Heritage Care Limited Mrs Janet Chadwick Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration. 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 individuals assessed needs. Condition of Registration. The home may provide short-term respite care to service users for periods not exceeding eight weeks in length. 6th September 2005 2. Date of last inspection 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. Approximately 40 service users use the facility, and all referrals for the service are through Social Services. Service users from Grantham continue to attend their usual day service, but those from out of area have in-house activities planned. Heritage Care do not charge fees for short breaks, but Social Services make a direct charge to service users for the service. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was undertaken using a review of all the information available to the inspector regarding the service history of 18 Harrow Street, and through visiting the home. The visit took place over 5 hours. The registered manager was on holiday, but the deputy manager was present during the visit. The main method of inspection used was called case tracking which involved selecting three people who were staying at the home at the time, and tracking the care they receive through the checking of their records, discussion with them and care staff, and observation of care practices and interactions. A tour of the premises was conducted. Documents connected with the running of the care home were also inspected. The manager completed a pre-inspection questionnaire, and four ‘Have Your Say’ leaflets were returned, which had been completed by relatives on behalf of service users. What the service does well: What has improved since the last inspection? 18 Harrow Street has been completely redecorated by staff, and new furniture, carpets and curtains have been bought. The home is now much brighter, and service user said that they are pleased with the improvements. Night staffing arrangements have been improved, with support available from the other bungalows if needed. All staff have had training in the moving and handling of residents, so that they can do this safely. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 18 Harrow Street DS0000034259.V306002.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 18 Harrow Street DS0000034259.V306002.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 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. Service users are introduced to the home in a sensitive manner, and staff have a good range of information to ensure that their support needs can be met. EVIDENCE: All referrals for short breaks are made through Social Services. Staff from 18 Harrow Street use a detailed pre-admission booklet, which they complete with the service user and their carers. This provides a wide range of information about likes, dislikes, preferred routines and support needs, and forms the basis of the care plan. A plan for introduction to the home is discussed with the service user and their carers, and will usually involve a few visits prior to an overnight stay. A parent said, “Parents and service user visited and talked to the staff. They were very helpful in answering many varied questions”. At the time of the visit, staff were planning for an emergency admission, following a service users main carer becoming ill. The gentleman had not stayed at Harrow Street before, so the deputy manager was looking at assessment information from Social Services. The care home that he usually stays at had also faxed across copies of their own care plans. When the gentleman arrived, he was introduced to other service users, shown around the home and offered refreshments. Staff reassured him when he became anxious, and talked to him about what activities that he would like to do. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 9 18 Harrow Street DS0000034259.V306002.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. Care plans accurately describe service users support needs, and service users are well consulted. There are good assessments in place to minimise risks to service users. EVIDENCE: Care plans are well organised, and each has a wide range of information about daily support needs. They contain good personal information, which documents likes, dislikes and preferred routines. However, they are not signed or dated, so it is not clear who wrote them, or when they did. Care plans are regularly reviewed, and a service user confirmed that staff had talked to her about its contents. All service users also have copies of their Social Services care plans on their files, which give staff further information. There are good daily records kept of day-to-day activities. Staff have a good knowledge of the way each service user communicates, in order to involve them in decision making and choices. One lady staying at the home communicated mainly by writing notes, and staff were using this to find out what her choices were. Other residents staying at the time of the visit could communicate verbally, but staff outlined other communication methods 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 11 they use if service users are cannot communicate like this. A service user said, “Staff always ask us what we want to do, what we want for tea – they are very good”. Service users are encouraged to be as independent as possible, whilst staying at Harrow Street. They can prepare snacks, and help with meals, and all have risk assessments about kitchen safety and other household risks. One lady was preparing her own lunch during the visit, and another said, “Staff let us do what we would do if we were at home. I help with the washing and ironing sometimes, but I’m on holiday, so I leave the staff to do the cooking” 18 Harrow Street DS0000034259.V306002.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, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A good variety of leisure activities and outings are provided to ensure that service users have an enjoyable stay. The food served caters for service users choices and preferences. EVIDENCE: Local people who use Harrow Street continue to go to their usual day services and colleges. However, transport is not provided for service users who go to Sleaford day services, and they would be expected to pay for a taxi. Service users staying at the time of the visit said that there are lots of activities. One said, “There is plenty to do – I never get bored – I like watching videos and playing on the computer”. Another said that she enjoyed reading. There is no activity timetable, but ideas are discussed with service users on a daily basis, depending on the interests of the people staying at the time. The home is close to the town centre, and since the last inspection, they now have a mini-bus for outings, which can take people who use wheelchairs. There are usually one or two activities each year where people wear fancy dress. Last year there was a 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 13 Hawaiian night and this year there has been a ‘Casino Night’, and a Wild West night is planned. Service users said that staff respect their personal space, and always knock on their bedroom doors before going in. Service users said that the food is good, and they can ask for the food that they like to be included in the menu. One said, “We can ask for our favourite meals here”. A list in the kitchen identifies service user’s likes and dislikes, and any special dietary requirements. 18 Harrow Street DS0000034259.V306002.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. Service users receive good support, and their health needs are catered for. There are safe procedures for the administration of medications. EVIDENCE: Service users said that routines in the home are flexible, and they have choice over how they lead their daily lives. Service users bring with them any special equipment they need. The home is equipped to care for people with mobility difficulties, with hoists, hi-lo bath and grab rails. A parent commented, “The manager of the home and the staff are very good, helpful and kind, and make us feel that our daughter is in good hands whilst away from home”. Service users said that the staff are very helpful and supportive. People from Grantham can still see their doctors during their stays, but those not from Grantham are registered with local doctors as visitors, to ensure that their health needs are met. However, service users would usually go home if they became ill during a stay. Arrangements for medication storage and administration are satisfactory. Parents are asked to complete a medication information sheet, giving details of current medication, before a visit. There is good guidance for staff about how 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 15 service users prefer to take their medication. One service user confirmed that she self-administers her medication, and that she has lockable storage space in her bedroom. Staff receive in-house medication training, and have to complete two written tests, and undertake observed medication rounds before being assessed as competent. 18 Harrow Street DS0000034259.V306002.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. The complaints and adult protection procedures ensure that service users are protected during their stays. EVIDENCE: There have been no complaints recorded since last year, and the complaints procedure is available to service users in an accessible format, using symbols. One service user said, “I have never had to complain about anything – I’m always happy here”. Parents commented, “The staff always act on what the client tells them”. Staff interviewed showed a good knowledge of the adult protection procedures, and who to report suspected abuse to. Heritage Care have a policy of providing adult protection training for staff every 3 years. Service users said that they felt safe during their visits. A parent commented, “Our daughter is a vulnerable young adult. Staff are aware of this and act to keep her safe whilst in their care”. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There have been major improvements to the home, which now provides accommodation of a high standard for service users to enjoy. EVIDENCE: Since the last inspection, the home has been completely redecorated by staff, with new carpets, curtains and furniture. Some bedrooms have been decorated to try to reflect male and female tastes, and service users all commented how nice the home is now. One said, “Its really lovely – the staff have put a lot of effort in”. A large gazebo has been erected over the patio area to provide shaded seating area, and work that was underway during the last inspection, that affected access to the rear garden, has been completed. Parents commented, “The accommodation is spotless, decorations are kept up to date, and it is an extremely comfortable and well run home”. Staff confirmed that maintenance issues are attended to promptly, and the home was clean and tidy at the time of the inspection. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 18 The previous inspection identified that some records are stored in the boiler room. Staff again complained that this room is too hot to work in, and methods of ventilation, such as an extractor fan should be explored. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff group have worked together for a long time, and they know the service users well. Training is well co-ordinated, but staff are overdue fire training. EVIDENCE: There has been no staff changes over the past two years, which has provided service users with continuity of care. There are two staff per shift, and this can be increased according to the number of people staying at the home, and the needs of service users staying at the time. Night staffing arrangements have now been made clearer, with additional support provided from other bungalows on the site if required. Some staff transferred from Mulberry Trust some years ago, and their staff records have been stored by the National Health Service. Attempts by Heritage Care to obtain these records have been unsuccessful. No new staff have been employed, so no staff records were inspected. Training is co-ordinated by a member of staff, and training dates are e-mailed from the training department. Each member of staff has an individual training record. Staff said that training opportunities are good, and heritage Care has the Investor in People Award. The previous inspection identified that some staff were overdue moving and handling training, and this has now been 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 20 provided. However, staff were due to have fire training in April, and this has not happened. Staff said that they are receiving supervision from the manager or deputy manager, and that they are well supported. However the supervision diary did not provide evidence of this, as it was largely blank. It is recommended that staff receive formal supervision six times per year. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and organised, and provides a safe environment for service users. EVIDENCE: The manager is a first level registered nurse, but does not hold an NVQ level 4 qualification in management. She has previously confirmed that she will be enrolling on the Certificate in Management Studies, but it was not possible to verify this at the time of the visit. Staff said that they feel valued and supported, and that communication was good within the home. They said that the home is very well organised and managed, and comments from service users supported this. Previous inspections have identified that Heritage Care conducts quality assurance reviews, but there was no information at the time of the visit about any recent surveys. The care manager undertakes regular monitoring visits, but reports from these visits were not available, and were provided to the commission after the inspection. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 22 Records in the home provided evidence of regular health and safety and maintenance tests, ensuring a safe environment for service users. The home is situated in an area liable to flooding, and has an emergency contingency plan for this. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 23 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 4 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 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 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 4 3 3 x 3 x 3 x x 3 x 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 24 No 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 YA35 Regulation 18(1) Requirement The registered person must arrange for staff to receive fire training on at least an annual basis. Timescale for action 30/09/06 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 YA36 Good Practice Recommendations It is recommended that staff receive formal supervision six times per year. 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Lincoln Area Office 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. Extracts may not be used or reproduced without the express permission of CSCI 18 Harrow Street DS0000034259.V306002.R01.S.doc Version 5.2 Page 26 - 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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