Inspection on 12/04/05 for 1a Tollgate Road

This inspection was carried out on 12th 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 but made no statutory requirements on the home.

Other inspections for this house

1a Tollgate Road 16/05/07

1a Tollgate Road 06/06/06

1a Tollgate Road 12/10/05

1a Tollgate Road 14/09/04

1a Tollgate Road 20/04/04

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 08/07/2008.

CARE HOME ADULTS 18-65 1A TOLLGATE ROAD LUDLOW SHROPSHIRE SY8 1TQ Lead Inspector JANET OXLEY Announced 12 April 2005 10:00 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. 1A TOLLGATE ROAD Version 1.10 Page 3 SERVICE INFORMATION Name of service 1A TOLLGATE ROAD Address 1A TOLLGATE ROAD, LUDLOW, SHROPSHIRE SY8 1TQ 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) 01584 877737 01584 878063 VISION HOMES ASSOCIATION MRS WENDY MORSE CARE HOME 5 Category(ies) of 5 PERSONS WITH LEARNING DISABILITY registration, with number of places 1A TOLLGATE ROAD Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: The home may accommodate 5 Adults with Learning Disabilities and within this number may accommodate 1 Young Person under the age of 18 years named attached schedule (not to be displayed). Date of last inspection 14 September 2004 Brief Description of the Service: 1 A Tollgate Road is one of 3 Bungalows, which were purpose built, on the same site in Ludlow, South Shropshire, which are run by Vision Homes Association. The project was set up in1991 in partnership with Bromford Corinthia Housing who own the properties.The home is registered to provide care and accommodation for 5 service users who are visually impaired and have additional physical and learning disabilities.The Registered Provider is Vision Homes Association, the registered manager is Wendy Morse and she is Line Managed by Martin Thomas, Head of Service. At the time of this inspection however Wendy was acting as the Assistant Service Manager and the acting manager of the home was Guy Nisbitt. Management arrangements will be finalised within the next 2 months. 1A TOLLGATE ROAD Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and commenced at 9.45am and lasted for 3.5 hours. It included observing activity within the home, inspecting the premises, looking at records and case tracking, talking to 5 staff. The Head of Service, acting manager and staff on duty were welcoming and helpful throughout the inspection. It was found that the National Minimum Standards assessed had been met with only minor exceptions, with a number exceeded, and that the overall quality of care provided was good. Due to their disabilities the service users are unable to communicate easily, however they appeared happy, content and very well cared for. Visitors, relatives and all visiting professionals have expressed complete satisfaction with the service and care the service users are receiving and have been complimentary regarding the management and care practices at the home. What the service does well: This is a home for adults with severe learning difficulties where the service users are looked after well. The staff greatly respect the service users and were seen to be following the very detailed individual care plans encouraging each to maintain current skill levels and take part in a wide variety of activities that they evidently enjoy and benefit from. The building provides a pleasant and personalised environment to live in. It was evident through discussions with staff and management that there are clear lines of accountability within the homes management structure and through discussions and observations it was considered that the management approach created an open and positive atmosphere from which the service users benefit. 1A TOLLGATE ROAD Version 1.10 Page 6 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. 1A TOLLGATE ROAD Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 1A TOLLGATE ROAD Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2 and4 The policies and procedures that are in place, and have been professionally followed, ensure that the home undertakes all necessary assessments for successful and satisfactory admissions to take place. EVIDENCE: Only one admission has taken place over the last 7 years, this was in June 2004. At that time a very full assessment was made, covering all the required elements of these standards, the home fully demonstrated its capacity to meet the assessed needs and the transition to being a resident at the home was conducted professionally and sensitively with all relevant persons involved. It was fully acknowledged that the Statement of Purpose required minor amendments. 1A TOLLGATE ROAD Version 1.10 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The current service users would not be able to voice decisions about their lives however each service user has a very detailed Personal Development Plan, which includes all aspects of daily living and care they require. Staff evidently respect service users rights and there is a constant monitoring and review process to ensure their identified needs are being met and very individualised care given. EVIDENCE: A full and professional Personal Development Plan is available for each service user. These plans are well set out and include all health issues, communication, community activity, daily living, personal care, relationships with others, leisure and recreational activities, community issues, adult education and orientation and mobility. They focus on aims, objectives and realistic goals for the service users in the months ahead. These plans are reviewed monthly by a named worker and are reviewed six monthly with all relevant persons. Annual workshops also take place when staff concentrate on individual service users and re-appraise each plan The service users continue to access a wide range of activities due to the imagination and willingness of staff to get involved in all aspects of their lives. 1A TOLLGATE ROAD Version 1.10 Page 10 It was evident through observations, examining records and discussions with staff that staff respect the service users rights and that despite the service users severe disabilities, staff continue to work sensitively and professionally in assessing their needs and wishes. Risk assessments have been developed for each service user and include support requirements for each individual. The member of staff responsible for health and safety issues updates these assessments regularly and they are included in staff induction, training and on going development. 1A TOLLGATE ROAD Version 1.10 Page 11 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) 1, 12,13, 14, 15, 16 and 17. The lifestyle of the service users living at this home is excellent and through a framework of activities, independence, personal and social skills they are encouraged to develop. Family ties are maintained and regular visits home and meetings with relatives are encouraged and supported. EVIDENCE: Such are the service users disabilities that they would not be able to enter a world of work however it was evident once again throughout the inspection methods used that service users are given every opportunity to learn and develop. Specialist intervention is used whenever necessary and on a regular basis with service users enabled to access all support services. Service users take part in many activities which include a path to increased independence and records and discussions with staff indicated that many community resources continue to be accessed, according to the service users needs and abilities. Community transport, shops, leisure centres and a number of other local resources are used. 1A TOLLGATE ROAD Version 1.10 Page 12 One service user has her own fully adapted vehicle and others share a people carrier, all available through the mobility scheme. Staff continue to seek ways of exploring service users rights however they are fully aware that they would not be able to ensure that they would not be influencing the service users choice. 1A TOLLGATE ROAD Version 1.10 Page 13 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 and 20. The health and personal needs of service users are very well met with evidence of regular review and of good multi disciplinary working taking place on a regular basis. EVIDENCE: Service user’s records and discussions with staff indicated that the staff continue to carefully monitor health needs, make appropriate referrals and appointments to health care professionals. The support of Doctors and Consultants is ongoing and there is a good relationship between the home and visiting professionals, who continue to speak positively regarding the management and care practices at the home. Behavioural changes of service users are also carefully monitored and plans and risk assessments for all activities are in place. When service users are admitted to hospital 24 hour support is provided by staff from the home. 1A TOLLGATE ROAD Version 1.10 Page 14 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 and 23. It was considered that all stated outcomes are fully met. Staff are sensitive and have developed methods to identify what service users like, dislike or object to in a commendable manner and robust procedures and practices are in place to ensure that individuals are protected from abuse. EVIDENCE: No complaints have been received in the past year, a full complaints procedure is available and given that the current service users would have difficulty understanding the concept of a complaint it was evident, once again, that staff are sensitive and have developed methods to identify what service users like, dislike or object to and explore new avenues in efforts to overcome the difficulties. A record has been set up to ensure that all issues raised on behalf of service users are recorded and that action is taken. Robust procedures are in place to protect service users from abuse and are included in all aspects of staff training. Physical restraint is only used to prevent injury in the way of straps on wheelchairs and cot sides, the use of which is satisfactorily documented. 1A TOLLGATE ROAD Version 1.10 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 29 and 30. The standard of the environment within the home is good, providing service users with a warm, safe and homely place to live. Necessary improvements have been identified and are in hand. EVIDENCE: The standard of cleanliness and hygiene was good on the day of the inspection. The kitchen has been refurbished. All of the service users have their own bedrooms with a sink unit. Bedrooms were seen to be individual and highly personalised. The environment in general is satisfactory and staff evidently work hard to maintain a warm and homely place. Refurbishment of the shower room and bathroom are now necessary. 1A TOLLGATE ROAD Version 1.10 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, 35 36. Service users are supported by a well trained and committed staff group who are meeting the needs of each individual in a sensitive and professional manner. EVIDENCE: Recruitment at the home is thorough and all elements required by Schedule 2 of the Care Home Regulations were found on the files of 3 staff who have been recently recruited. Vision Homes Association continue to support staff to undertake their NVQ 2 award, a variety of other training has been undertaken and staff on duty indicated that they were very sensitive to the service users complex needs and disabilities and that their attitudes and practice were monitored and supervised by the management. The requirement made pays reference to the need to conduct annual appraisals and a recommendation has been made for the staff files to be maintained in a more professional manner. 1A TOLLGATE ROAD Version 1.10 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 and 42. There are clear lines of accountability within the homes management structure and the management approach creates an open and positive atmosphere from which the service users benefit. The home regularly reviews all aspects of its performance through a programme of self review and consultations and meets the requirements of the Fire Officer and Health and Safety Officer, promoting the health, safety and welfare of the service users. EVIDENCE: The manager has almost completed the Advanced Management in Care and the Registered Managers Course and he has had many years experience and has worked at the Vission Homes since opened. The manner in which management and staff responded to this inspection indicated that a sound management approach is in place and that staff are committed to achieving best practice and to developing equal opportunities. 1A TOLLGATE ROAD Version 1.10 Page 18 Sound quality assurance systems are in place and there was evidence available to indicate the manager ensures, so far as is reasonably practical, the health, safety and welfare of service users and staff. 1A TOLLGATE ROAD Version 1.10 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 4 x 4 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 4 2 3 3 x Standard No 11 12 13 14 15 16 17 4 4 4 4 4 3 x Standard No 31 32 33 34 35 36 Score x 3 3 3 x 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x 1A TOLLGATE ROAD Version 1.10 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. 2. 3. Standard 1 27 36 Regulation 4(1) 23(2)(j) 18(2) Timescale for action That the Statement of Purpose Without be ammended to ensure that it is delay. up to date and acurrate. That the bathroom and shower 18 October room be refurbished. 2005 That all staff have an annual 18 October appraisal with their line manager 2005 to review performance against job description and agree career development plans. Requirement 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 34 Good Practice Recommendations That staff files be maintained in a more professional manner. 1A TOLLGATE ROAD Version 1.10 Page 21 Commission for Social Care Inspection 1st Floor, Chapter House South Abbey Lawn, Abbey Foregate Shrewsbury SY2 5DE 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 1A TOLLGATE ROAD Version 1.10 Page 22 - 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. 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