Inspection on 16/01/07 for 1c Tollgate Road

This inspection was carried out on 16th January 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

1c Tollgate Road 01/11/05

1c Tollgate Road 03/05/05

1c Tollgate Road 09/12/04

1c Tollgate Road 24/06/04

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 1c Tollgate Road Ludlow Shropshire SY8 1TQ Lead Inspector Sue Woods Key Unannounced Inspection 16th January 2007 10:15 1c Tollgate Road DS0000020652.V327676.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 1c Tollgate Road DS0000020652.V327676.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. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 1c Tollgate Road Address Ludlow Shropshire SY8 1TQ 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) 01584 877166 01584 878063 Vision Homes Association Mrs Colleen Shuker Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st November 2005 Brief Description of the Service: 1C Tollgate Road is one of three bungalows, which were purpose built, on the same site in Ludlow, South Shropshire, and run by Vision Homes Association. The project was set up in 1991 in partnership with Bromford Corinthia Housing who own the properties. The home is registered to provide care and accommodation for five service users who are visually impaired and have additional physical and learning disabilities. The Registered Provider is Vision Homes Association. Colleen Shuker has been the manager since July 2003. She is supported by Julie Evans, deputy manager and currently line managed by Wendy Morse, Acting Assistant Service Manager. Consultation with service users takes the form of discussions, regular observations and detailed care and support plans that identify and review likes and dislikes. Current fees for the service range from £58,663 to £87,536 per annum. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of 1C Tollgate Road was carried out 16th January 2007 from 10.15 am until 1.15 pm. The inspection reviewed all 22 key standards and information to produce this report was gathered from the findings on the day and also by review of information received by CSCI prior to the inspection date. A quality rating based on each outcome area for service users has been identified. These ratings are described as excellent/good/adequate or poor based on findings of the inspection activity. As part of the fieldwork activity the inspector met four service users, spoke with all of the staff on duty and reviewed care files as well as other documentation referred to within the report. Observations made during the inspection are also referenced. What the service does well: The service provided at 1C Tollgate Road is very much service user focused with people being supported by an established, committed and well trained staff team. Due to the flexibility of the team activities can be arranged around individual needs enabling excellent opportunities both within and outside of the home. The staff team demonstrate excellent communication skills and it is evident that their knowledge and enthusiasm ensure that service users have a good quality of life. Care files and other records are well maintained and up to date. Service users access a wide range of activities and are actively involved in all decision making processes within the home. The manager is well respected by the team and the deputy manager continues to provide excellent support and leadership when the manager is not on duty. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 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 report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 1c Tollgate Road DS0000020652.V327676.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 1c Tollgate Road DS0000020652.V327676.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Appropriate procedures are in place that would enable the successful admission of a new service user to the home however no admissions have taken place over the last year. EVIDENCE: There have been no new admissions to the home since the time of the last inspection therefore the judgement made at the time of the last inspection will be carried forward. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Person centred care and support plans enable staff to offer service users choice and assist with decision making as well as delivering care in a way that they prefer. Risk assessments ensure that support is given in a safe manner. EVIDENCE: Two care files were reviewed at the time of this inspection. Both contained a detailed care and support plan and a comprehensive Health Action Plan. Staff commented that profiles were helpful to them in delivering personalised care and the format was ‘easy’ to work with. It was also stated that, because staff turnover is low, staff are very aware of the individual care and support needs of service users and proactively advocate for them. Care files contained reviews from various supporting bodies. Detailed records of foods eaten were seen on both files reviewed. Guidelines were in place to support the use of medications taken as and when 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 10 required and these had been updated in July 2006 by the manager. The pictorial guidelines to support the use of one person’s ‘stand aid’ were particularly impressive to enable a consistent approach. Service users access a wide range of activities and staff told the inspector about the numerous holidays that they had been involved in and how much they had been enjoyed by service users. This was reflected during discussions with service users. During the inspection service users were actively involved in all decision making processes and the daily routine was seen to be totally service user led. Risk assessments support activities. Records reflect that assessments have been recently reviewed. One ex member of staff is now acting as an advocate for one service user and staff felt that this arrangement was very positive for the individual. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,15,16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users lead full and active lives with opportunities to participate in new and exciting activities of their choice. Service users benefit from a balanced and varied diet. EVIDENCE: Service users either individually or with support from staff told the inspector of numerous activities that they undertake on a regular basis. Plans for the day are agreed and staff are designated to offer support. Staff demonstrated flexibility to support a range of activities on the day of the inspection. Activities are ultimately dependant on how the service user feels on the day. Activities range from shopping to going to a nightclub. One service user showed the inspector her knitting and said that she had recently completed a cardigan. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 12 Through discussions staff demonstrated that they were aware of very detailed information about service users preferences. Care files reflect that service users attend various ‘therapies’ on a regular basis. Service users have the use of designated cars for when they go out and the deputy manager also reported that the new park and ride scheme offers easy access to buses. Family contact is promoted and encouraged wherever possible. Staff have addressed issues of equality and diversity in relation to the need for male contact for the all female service user group. The deputy manager identified how they attempt to ensure male support is available as appropriate. Records of foods eaten by two service users were seen by the inspector. They suggested that service users eat a nutritious and healthy diet. A well-stocked fruit bowl was seen in the kitchen. Service users with special dietary requirements are well supported. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from a knowledgeable staff team who support them in ways that they prefer. Service users are protected by effective systems for the storage, recording and monitoring of medication. EVIDENCE: At the time of the inspection one service user became unwell. The inspector was able to observe the staff team support the individual sensitively and discreetly in a caring and professional manner. The staff team knew exactly what needed doing and did it with minimum disruption to others in the room. The service user was moved using appropriate moving and handling techniques to her room where she was monitored as she recovered. Other interactions such as supporting service users to see the visiting optician were equally as professional. Staff support service users to be as independent as possible and this is recorded in daily records. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 14 Medication arrangements seen at the time of the inspection were satisfactory. The medication cupboard was well organised and records suggested that service users have medication at the correct times in the correct doses. The deputy manager stated that she had reviewed the previous MAR sheets and there had been no gaps or errors made. The deputy manager also stated that the secured box used to store controlled medication is to be replaced with a more secure structure. Records of medications received and returned to the chemist were also seen to be up to date. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected by staff being aware of procedures for managing concerns and complaints and by operating an open and accountable system of supporting service users to manage their money. EVIDENCE: The personal accounts book for one service user, chosen at random, was seen by the inspector. Records detailed that regular personal allowance payments are received by the service user. Transactions were well recorded and receipts were retained wherever possible. Money on site reflected the total recorded in the book. The deputy manager detailed measures in place to safeguard service users money. The home has received no complaints in relation to the service within the last twelve months. A book is available should a complaint be raised to record basic information and outcomes. Staff who spoke with the inspector were aware of the complaints and whistle blowing procedures. Staff had recently received a letter commending the service and the deputy manager stated that when it had been seen by everyone then it would be kept in the complaints and compliments book. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are provided with a clean, well-maintained and safe place to live. EVIDENCE: Since the time of the last inspection of the home the kitchen has been completely refurbished and the lounge dining room has been re decorated. Two service users bedrooms were seen by the inspector. Both were spacious and had been personalised. A new bath has been installed in the bathroom and the bathroom tiles have been painted. The deputy manager reported that a representative from Bromford (the Landlord of the home) had visited earlier in the day to carry out routine water safety checks. Water temperatures were taken at the time of the inspection by a designated support worker who also carries out the checks at other properties on the site. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 17 It is noted that due to the individual behaviours of one service user plans are being made to move the office to the property next door for a short period of time to enable the room to be used as an additional lounge facility. All service users will be able to use the space but the main user is currently involved in producing artwork from noise reducing materials. The service user stated that she is enjoying this project. The optician saw service users in their bedrooms, as there is no additional communal private space. By making available a second lounge area this problem will be alleviated. All areas of he home were seen to be immaculately clean. Portable Appliance testing takes place annually and stickers on items reflect they are next due for testing in February 2007. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 33, 34 and 35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by well-trained and competent staff in sufficient numbers to delivery a user led service. EVIDENCE: The inspector had the opportunity to speak with staff in private and also jointly during the daily handover meeting. All staff on duty were friendly and totally professional, demonstrating a good understanding of the needs of service users and a relaxed approach to situations as they arose. Staff demonstrated competence and excellent communication skills during an incident with one service user. Staffing levels at the time of the inspection were good and sufficient to support individual identified activities. Staff have a communication book to share information of a general nature between shifts. The majority of staff now have NVQ level 2 and/or level 3. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 19 All staff stated that they really enjoyed their work and staff spoke highly of the manager and the support they receive. Two staff have been recruited to the team since the time of the last inspection. Their files were reviewed and found to contain all required information with the exception of one proof of a CRB disclosure. A letter evidencing this was later found ready to file. The induction file of one staff member was seen to be very detailed and there was evidence that it was a working document. Staff commented that training opportunities for staff are excellent within the organisation. Staff spoke of numerous training opportunities. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 37, 38, 39 and 42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users benefit from being supported by an effective management team. The health, safety and welfare of service users and support staff is promoted and protected. EVIDENCE: The manager of 1C Tollgate Road was unavailable on the day of the inspection but staff said that she was very supportive and was approachable no matter what the issue. The deputy manager, who was on duty at the time of the inspection, should be commended for her in depth knowledge of the service, service users and staff team and for her relaxed and professional approach. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 21 Systems and processes are in place to ensure the home runs smoothly and staff were aware of their individual responsibilities and roles. Health and safety representatives ensure that safety issues are regularly monitored and records are kept up to date. The fire safety book reflected that routine checks take place on a regular basis. Staff spoke knowledgeable about various health and safety procedures. Arrangements for the storage and recording of COSHH products are good and data sheets and risk assessments are stored with the products. Paperwork for two products chosen at random was readily available. Staff advocate on behalf of service users and family support is valued. Consultation with service users takes the form of discussions, observations and detailed care and support plans that identify and review likes and dislikes. During a telephone conversation the day following the inspection, the manager was able to confirm that regulation 26 visits are now happening again. 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 22 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 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 4 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 3 X X 3 X 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE National Enquiry Line: 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 © 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 1c Tollgate Road DS0000020652.V327676.R01.S.doc Version 5.2 Page 25 - 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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