Inspection on 24/10/08 for 183 Ashby Road

This inspection was carried out on 24th October 2008.

CSCI found this care home to be providing an Good service.

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

183 Ashby Road 30/10/06

183 Ashby Road 12/10/05

183 Ashby Road 25/05/05

183 Ashby Road 13/09/04

183 Ashby Road 24/05/04

183 Ashby Road 25/02/04

183 Ashby Road 13/10/03

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 30/03/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 183 Ashby Road, 183 Ashby Road, Burton On Trent Staffordshire DE15 0LB     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: User doesnt belongs to any group     Date: 2 4 1 0 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 183 Ashby Road, 183 Ashby Road, Burton On Trent Staffordshire DE15 0LB 01283533822 F/P01283533822 Shaun.mitchell183@robinia.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Robinia Care Homes (2) Limited care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 5 LD - aged 18 to 26 on admission Date of last inspection Brief description of the care home The service is provided from a large semi-detached property, located on a busy main road, in a residential area of Burton-on-Trent. It is close to local amenities and within walking distance of the local shops, park area and pub. The service has its own vehicle but is also close to public transport links. The home provides for up to 5 people in single occupancy bedrooms: none have en-suite facilities, all have wash hand basins fitted. Communal space is provided in a pleasant lounge, dining room and spacious well-equipped kitchen. The service is registered to provide care for persons over the age of 18 years who have a learning disability. In the guide to the home it states that the annual fees range from sixty seven thousand seven hundred and thirty one pounds to a maximum of one hundred and twelve thousand seven hundred and thirty two pounds. 5 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This unannounced key inspection was carried out by a single inspector between 0915 and 1610. As part of the inspection all National Minimum Standards defined as key by the Commission for Social Care Inspection were inspected. Information about the performance of the home was sought and collated in a number of ways. Prior to the inspection we were provided with written information and data about the home through their Annual Quality Assurance Assessment, which details how the home feels it meets the needs of people living there. Information from the last key inspection report was analysed prior to inspection and this helped to formulate a plan for the visit. On the day of the inspection we looked at Care Homes for Adults (18-65 years) Page 5 of 27 several records, spoke to people living there, the manager and staff, undertook a tour of the building and observed practice, which all helped in determining a judgement about the quality of care the home provides and how successful it is in meeting outcomes for people living there. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have their needs assessed and reviewed regularly and are involved in day to day matters as much as possible. Evidence: The action support plans kept by the home contain very useful information that show how outcomes for those using the service are being met. They are based on the assessment of need received at the time of admission and are reviewed and updated as the home becomes more familiar with the people living there and their needs and preferences. An example of this was seen on the action support plan for one person who has a fascination for trains and anything to do with Eddie Stobart transportation. Assessments of risk are included in the action support plan and these too are regularly reviewed and updated. When a prospective admission is being considered by the home the people currently living there are consulted to help the home decide whether the prospective admission will be compatible with those already living there. One of the people living at the home Care Homes for Adults (18-65 years) Page 9 of 27 Evidence: told us that this is what happens and that it helps to keep the home a friendly place. The welcome guide does not fully meet the communication needs of those living at the home and needs to be improved to provide information in a more useful and interesting format. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A considerable effort is made to involve people living at the home as much as possible in the day to day running of the home. Their needs are well documented and acted on by staff. Evidence: We found a lot of evidence to show that people living at the home have a considerable amount of say in their everyday lives. We observed several conversations during the day between members of staff and people living at the home about a range of things such as food choices and activities. Independence is encouraged but staff also know what degree of independence each person is capable of. The action support plans are very person centred, meaning that each individual has their needs carefully considered to ensure they can live successfully within the group environment. Considerable thought has gone into the action support plans and they are regularly reviewed. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Where a risk to a person living at the home or others is identified the home is quick to put in place a way of dealing with it. One person living at the home has a history of exposing himself. Sometimes he does this from the sitting room window to passers by. Initially the home made sure that a member of staff was always in the sitting room with him. When he made it known he was unhappy with staff always having to be in the room with him a decision was made to put screening on the window that allowed people to see out but stopped passers by from seeing in. This is a good example of risk being managed while still responding to the expressed wishes of the people living there. We saw consultation forms in the action support plans and a member of staff told us how they respond to individual needs following consultation. One person living at the home does not like sitting and form filling so his keyworker completes assessments and plans on his behalf and then reads it to him. At this stage he can add things or ask for changes before the final version is put on his file. The home believes that anyone admitted to the home will need to be compatible with those already living there. When a prospective admission is being considered the manager informs all the people living at the home and lets them know when pre admission visits are planned. We witnessed an example of an individual making choices about food. Although a member of staff explained a number of healthy options for breakfast the individual chose instead to make himself a burger in a bun. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home benefit from a lifestyle that is respectful of their preferences and suited to their abilities. Staff are responsive and show a genuine commitment to helping individuals achieve to their maximum potential. Evidence: There is a strong commitment by the home to encourage and support as much independence as each person is capable of. This is evidenced in a range of ways, including choice of food and when meals are taken. We observed staff helping people living at the home with their social skills, such as saying hello to visitors and asking them if they would like a drink. Discussion with staff and people living at the home satisfied us that areas of vulnerability and potential risk were well known and well managed. Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: Contact with family and others who are important to the individual is encouraged and supported by the home. The home is very responsive to particular interests of individuals. One example of this is taking a person who lives at the home to railway stations to watch trains, which is a fascination of his. The same person is also extremely knowledgeable about all things to do with Eddie Stobart lorries. We were impressed with the awareness shown by staff of how important these things were to him. Discussion with people living at the home satisfied us that they have as much involvement in planning for their lifestyle as they wish and they have the chance to make decisions about their everyday choices. Being part of the community is seen as very important and staff support all those living at the home in developing their skills to enable them to attend college and take up employment opportunities when they arise. The home liaises with employment specialists where there are queries or difficulties relating to disability rights or entitlements. One person living at the home has total independence with regard to the food he prepares and eats, another tends to eat what he fancies at the time and the third has a planned menu. The different approaches are responsive to individual preference but makes it more difficult to monitor nutritional intake, although staff do record what is actually eaten so there is some degree of nutritional intake monitoring. Staff make effort to monitor weight gain and loss but the person who is independent in terms of food refuses to be weighed. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals have their personal and healthcare needs met through a combination of a sensitive and responsive approach from staff. Medication practice safeguards people living at the home from potential risk. Evidence: Personal and healthcare support is very person centred, meaning that each individual has their particular health and care needs carefully considered and responded to. Healthcare plans are included in the action support planning process used by the home. We found staff to be sensitive and responsive to the needs of individuals and this was reflected in brief discussions held with two people living at the home, who both spoke very positively about how well cared for and supported they were. We observed how well staff listen, and respond, to what is important to people living at the home. Because all three living there are able to express their healthcare needs without particular difficulty the home encourages them to make and attend medical appointments as and when necessary. The training programme provides evidence that staff have access to a range of training that helps them to manage personal and Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: healthcare matters professionally. Medication practice is consistent with good practice guidelines and records of receipt, administration and disposal show that people living at the home are properly safeguarded in this area. The medication cabinet meets regulatory requirements. The medication records we checked were completed fully and all were signed by the person giving the medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home said that they feel safe and able to say if this was not the case. Evidence: People living at the home are provided with a complaints guide written in language that is suitable for their level of understanding. From brief discussions with two people living there we are satisfied that they understand about complaints and have no concerns about making one if they felt they needed to. Complaints that have been recorded show that the home takes them very seriously and responds in a way that resolves the concerns of the person making the complaint. Response to one particular complaint also recognised the need to safeguard the person who was the subject of the complaint from potential repercussions. Awareness of, and knowledge about, safeguarding is good, satisfying us that people living at the home are protected from potential harm that may result from their own behaviour or from things beyond their control. Training in adult protection is seen as important and refresher training is seen as necessary to ensure staff knowledge is kept current. People living at the home are further safeguarded by a clear whistleblowing policy, explaining how anything that may adversly affect them should be dealt with. Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: To make sure staff have the skills and have confidence in dealing with any potential episodes of aggression the home trains staff in using Team Teach methods. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individuals benefit from a living environment that is suited to their needs, is safe and is responsive to their choices. Evidence: The first impression upon arrival at the home is a little strange because the big window to the left of the main entrance is blacked out. The reason for this is well documented and has been done in response to a safeguarding concern, but it seems a little strange on first sight. Once in the home there is an immediate homely feel and both staff and people living there are very welcoming. All living there are white, British males and the general feel and look of the home is reflective of this. Observation of, and discussion with, people living at the home satisfied us that they are happy with their living environment. Staff stated that it would be nice to have some of the furniture updating but the general quality of furnishings is nonetheless of a satisfactory standard. The bedrooms have been personalised to reflect the preferences of the people living there and one person who showed me his room said it was big enough for him and that he had a lot of say in how it how it should be. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Awareness of, and adherence to, health and safety requirements is satisfactory and infection control practice helps to safeguard people from potential risks. The fire self assessment that was undertaken by the home in December 2007 details how the home protects staff, visitors and people living there from the potential risks associated with fire. Staff were not able to find a recent Environmental Health Officer report but we did see one from 2004. Our observations on the day raised no obvious concerns but because of the potential risks to those living at the home from cross infection we feel this is a safeguard that should be pursued. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are cared for by a flexible, mutually supportive and committed team of care staff who understand and respond to their needs and preferences. Evidence: The relationship between staff and people living at the home was very relaxed and respectful. Staff showed good listening skills and were responsive to expressed choices made by individuals. Discussion with one member of staff satisfied us that knowledge acquired through training informed how she developed her practice to provide a better service to the people living there. The commitment to qualifying staff gives further evidence of how the home seeks to develop the skills and knowledge of the staff team to help them provide a better service to individuals. The staff team are willing to work flexibly, providing people living at the home with a consistent group of carers who know their needs. The rota shows there is sufficient cover to ensure individuals can be provided with the level of support they may need or request. There is a waking night on every night and staff explained they feel this is Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: necessary as there is one person who can become quite frightened when there are heavy winds or storms. The recruitment procedure used by the home is robust and involves all the necessary safeguards to ensure that staff appointed will provide a safe service to the people living there. Staff were very clear that support to them was excellent and were unable to identify anything with regard to support that they felt needed improvement. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The ethos, systems and care practice help to provide safe care for people living at the home. Consultation is taken seriously and informs change, which benefits those living there. Evidence: The manager keeps the interests of people living at the home as the main focus (a person centred approach) and this is reflected in the general running of the home. He is suitably qualified and has many years of relevant experience. He is supportive, both formally and informally, of his staff team, evidenced by comments made during our discussions with members of staff. There is evidence that people living at the home are encouraged to influence the way the service operates to ensure their needs and preferences are met successfully. Information in the Annual Quality Assurance Assessment, a document completed by the manager to explain how the home meets the needs of people living there, shows how they provide safe and consistent care and how they respond to consultation to Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: improve what it does. We found evidence through records and discussion with the manager of ongoing review of the service to ensure that people living there can develop to their potential. Our observation on the day provided evidence of a well motivated staff team who feel supported through formal structures such as supervision but also through informal support. Health and safety standards are monitored and maintained satisfactorily. Records we looked at provided evidence that necessary checks are carried out. There is a need for the annual development plan for quality assurance to be updated as it was last done in October 2006 and this is a recognised tool for showing how outcomes for people living at the home are being met. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 1 The welcome guide for people living at the home should be updated to make it more appealing and suitable for their communication needs The home should arrange for an Environmental Health Officer to visit to ensure that the home is meeting all requirements and safeguarding people living at the home from potential infection related risks The annual development plan for quality assurance should be updated to show how the home is reflecting the views and outcomes for people living at the home 2 30 3 39 Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!