Inspection on 06/09/05 for 18 Harrow Street

This inspection was carried out on 6th September 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

18 Harrow Street 28/07/06

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 15/02/2010.

CARE HOME ADULTS 18-65 18 Harrow Street 18 Harrow Street Grantham Lincolnshire NG31 6HF Lead Inspector Mick Walklin Unannounced 06 September 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. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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 only 5 Category(ies) of LD Learning disability - 5 registration, with number of places 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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 21 April 2005 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 V248106 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over a 7 hour period. There were two service users staying at the time of the inspection. The main method of inspection used was called case tracking which involved tracking the care the two service users receive, through the checking of their records, discussion with them, the care staff and observation of care practices. Six comment cards were received from relatives, which contained positive feedback. Two parents were also interviewed. A tour of the premises was conducted. Documentation within the home was also inspected. 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 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 V248106 060905 Stage 4.doc Version 1.40 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 V248106 060905 Stage 4.doc Version 1.40 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 & 4. There are good procedures for assessing and introducing new people to the home, to ensure that there needs are met. EVIDENCE: The updated Service user Guide is ready to be sent out to all service users, but due to recent management changes, the manager is awaiting a photograph of the new Head of Care before sending them out. Both service user files inspected contained detailed pre-attendance booklets containing wide-ranging information about them. One service user said that she was due to be introduced to the service last year, but a situation arose which led to her be admitted for emergency respite care. She said, “This was really scary, because I didn’t know the home – but staff were really helpful and made me comfortable. I now have regular stays, and look forward to them”. A parent described how her son had encountered difficulties during a stay earlier in the year, which had caused concerns. However, there had been careful planning between the family and the home for his last stay, which had gone well. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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, 7, 9 & 10. There is excellent communication with parents, who are fully involved in the care planning process. Services are consulted and offered choices relating to their lifestyle whilst staying at the home. EVIDENCE: Care plans clearly outline the care needs of service users, but the two people case tracked were both very independent, and had low care needs. There are good daily records giving a detailed account of the stay, and risk assessments have been updated. These now give staff clear guidance on how to minimise risks, and are reviewed every 6 months. Parents said that communication with the home is excellent. Parents are sent a copy of the care plan for agreement, and one service user said that staff had explained her care plan to her. Both service users said that staff listen to their opinions, and they can make choices relating to their daily activities. One said that there are some restrictions on her accessing community facilities, but she has agreed these with staff, and understands why they are necessary. She also said that there is an agreement that staff will wake her in the morning. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 9 Staff explained that many people who use the service do not have verbal communication skills, and techniques such as signing, use of pictures, symbols and objects of reference are used to ascertain choice. Staff were clear on their responsibilities regarding maintaining the confidentiality of service users. The boiler room is used to store records, and this is now kept locked. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 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) 12, 14 & 17. A variety of leisure activities and outings are facilitated to ensure that service users have an enjoyable and stimulating stay. Catering arrangements reflect service users choices and preferences. EVIDENCE: Local people who use the service continue to access their usual day service/college. However, transport is not provided for service users who access Sleaford facilities, and they would be expected to pay for a taxi. One service user said, “I enjoy my stays as I get out a lot”. She had been shopping in the morning, and helping with newspaper deliveries in the afternoon. The other service user had been a college all day. The home does not have its own transport, which affects outings. The home is situated close to the town centre, but outings further afield rely on public transport, or staff using their own cars. At the time of the last inspection, the manager had been promised a minibus that was being used by another scheme, but this had not materialised as yet. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 11 One parent commented that the mix of service users and their dependency affected outings. Catering arrangements are of a domestic nature, with care staff responsible for food preparation. Both service users said that the food is good, and their preferences are catered for. A list in the kitchen identifies service user’s likes and dislikes. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 12 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) 19 & 20. There are satisfactory arrangements for meeting the health needs of service users. EVIDENCE: A parent confirmed that if her son became ill, she would be contacted, and a decision would be made about the best course of action. 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. There was no medication stored at the time of the inspection, but facilities are satisfactory and staff receive training, which includes an assessment of competence. A register has been purchased for medication requiring robust storage and stocktaking. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 13 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. Service users and parents have confidence in the complaints procedure. There are robust procedures to ensure that service users are protected. EVIDENCE: There have been no complaints since the last inspection, and the home has received three compliments. The complaints procedure is displayed prominently in the hallway, and is contained in the Service User Guide. A service user stated that she would feel confident that staff would act on any complaints. One parent said that she had expressed concerns about being contacted during her son’s stay, and these issues were resolved by the manager. The parent felt that her concerns had been taken seriously. She said that she is “totally confident in the homes ability to care for her son”. Staff have had recent training updates relating to the protection of vulnerable adults. Those staff interviewed were clear on their responsibility to report concerns, and were able to outline what action they would take in a given scenario. Both service users said that they felt safe and protected whilst staying at the home. The home does not have a copy of the latest version of the Lincolnshire Adult Protection Committee guidance, and the manager agreed to obtain a copy of these. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 14 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 & 30. The home provides a homely and comfortable environment for service users during their stay. EVIDENCE: The home is comfortable and brightly decorated, and both service users were happy with the accommodation. A computer has been installed in the lounge since the last inspection. The rear garden cannot be used by service users at present because the Environment Agency are undertaking flood prevention work. However, the side garden has been extended and a gazebo erected. This gives service users a large covered patio area with tables, chairs and a barbeque to enjoy. Staff confirmed that maintenance issues are attended to promptly, and the home was clean and tidy at the time of the inspection. As previously mentioned, records are stored in the boiler room. This room is too hot for staff to work in, and it is recommended that methods of ventilation, such as an extractor fan be explored. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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) 33, 34, 35 & 36. The staff group is very established, and staff are well trained. Night staffing arrangements require clarification, and some staff records are incomplete. EVIDENCE: The home is fully established, and staff service users and parents confirmed that there are sufficient staff to meet the needs of service users during the day. Staff turnover is very low, and no new staff have been recruited since the last inspection. The staff group have worked together for a long time and know the needs of the residents well. The home has one waking night staff who works 20 hours per week. For the remainder of the week, one staff sleeps in. The sleep-in for the remainder of the site also sleeps at the home, but is not regarded as part of the staffing establishment. In order to meet minimum staffing requirements, this person must be considered as part of the establishment. Some staff transferred from Mulberry NHS Trust, and their staff records have been archived. It is recommended that the manager obtain missing documentation such as references so that staff files contain the required documentation. Staff said that training opportunities are good, and the organisation holds the Investor in People Award. However, some staff are overdue for a moving and 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 16 handling update, due to a course arranged for April being cancelled. Three staff have completed NVQ level 2, and three are working towards level 2 and two are working towards level 3. Staff confirmed that they are receiving supervision from the manager or deputy, but it is recommended that staff receive formal supervision six times per year. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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 & 42. The home is very well organised and managed. Health and safety documentation is good, ensuring service users are safe. EVIDENCE: The manager is a first level registered nurse, but does not hold an NVQ level 4 qualification in management. She confirmed that she will be enrolling on the Certificate in Management Studies course. A parent said that the home is well organised and managed. Staff described the manager as firm, fair and flexible, and said that the home is very well managed. Staff feel consulted about the running of the home and valued for the work that they do. There are regular team meetings, usually every month, and a newsletter is produced for parents three times per year. Parents said that communication with the home is excellent. Parents commented that they had received a questionnaire about standards of care from Heritage Care Head Office, but complained that it was not relevant 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 18 to respite care. The previous Head of Care confirmed that a report from this consultation exercise had not been produced. At the time of the last inspection, the fixed electrical wiring test was overdue. The manager confirmed that this had now been checked, but the home did not have a copy of the certificate. Testing of some portable electrical equipment had not been conducted, but a member of staff has been trained to conduct tests, but is awaiting the course results. For this reason, no requirement was made. Circuit breakers are available if service users bring their own electrical equipment in. Health and safety documentation was of a good standard and well organised. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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. 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 3 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 x 3 x x 3 Standard No 31 32 33 34 35 36 Score x x 2 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 18 Harrow Street Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 4 3 x x 3 x C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 Page 20 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 33 Regulation 18(1) Requirement Timescale for action 31/10/05 2. 35 18(1) The registered person must ensure that staffing arrangements at night are sufficient for the needs of service users. The registered person must 31/12/05 ensure that staff receive moving and handling updates. 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. Refer to Standard 24 34 36 37 Good Practice Recommendations It is recommended that methods of ventilation, such as an extractor fan be explored for the boiler room. It is recommended that the manager obtains missing documentation such as references so that staff files contain the required documentation. It is recommended that staff receive formal supervision six times per year. It is recommended that the registered manager undertake NVQ level 4 in management, or equivalent training. 18 Harrow Street C53-C04 S34259 18HarrowStreet V248106 060905 Stage 4.doc Version 1.40 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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