Inspection on 11/01/06 for 2 Princess Close

This inspection was carried out on 11th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

2 Princess Close 01/04/09

2 Princess Close 08/04/08

2 Princess Close 13/06/07

2 Princess Close 12/01/07

2 Princess Close 26/09/05

2 Princess Close 03/03/05

2 Princess Close 26/08/04

2 Princess Close 11/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOMES FOR OLDER PEOPLE Princess Close 2 Princess Close Keynsham Bath & N E Somerset BS31 2NG Lead Inspector Sarah Webb Unannounced Inspection 11.15 11 January 2006 th X10015.doc Version 1.40 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 Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 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 Older People. 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. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Princess Close Address 2 Princess Close Keynsham Bath & N E Somerset BS31 2NG 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) 0117 9077222 0117 9699000 The Brandon Trust Ms Heather Hinton Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5) of places Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26th September 2005 Brief Description of the Service: 2 Princess Close is a detached house, situated in a quiet cul-de-sac, in a residential area of Keynsham. The house has been extended to provide accommodation for five people with learning disabilities. There is currently full occupancy. There is an agreed variation in the conditions of registration permitting the accommodation of a named service user under the age of 65. On the ground floor there is a lounge, kitchen and dining room. Also on this floor are two bedrooms, a toilet, utility area, and and a walk in shower. There is a stair lift to the first floor where there are three bedrooms, a large fourth room currently used as a staff sleep-in/meeting room and a small office space. There is also a bathroom with specialist bath and separate toilet. At the rear of the property, there is a patio and small garden that can be accessed by means of a ramp. The home is within easy access of local amenities that include a leisure centre, shops and a park. There are accessible transport routes to both Bath and Bristol by both bus and train, and there are bus routes to other local areas. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 4.75 hours and was carried out as an unannounced inspection. The inspection methods used included record and documentation checks, case tracking, and discussion with 2 staff. The manager was unavailable; staff on duty were helpful and able to provide the appropriate information needed. Requirements made through the previous inspection have been met barring a requirement that is still being dealt with on a higher level between the Commission for Social Care Inspection and The Brandon Trust concerning the keeping of staffing records on site. Three residents were at home during the day with the other 2 returning from day services during the course of the day. One resident was able to talk about the activities they attended, how they are consulted, and how staff supported them in other aspects of their lifestyle. What the service does well: What has improved since the last inspection? Advice has been obtained from GP and consultant regarding personal epilepsy plans to include specific individual procedures to be followed as to when into a seizure. An action plan has been set out in order to demonstrate that the outcome by other means of training for a staff member meets with that of a National Vocational Qualification; to include how the home will monitor their development and how the manager will evidence their competence. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 6 Both staffing records and a training matrix have been updated. The home has improved in keeping a consistent record of staff attending fire drills. 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. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 4 The assessed needs and preferences of residents are met and there are processes in place for the review of their care. EVIDENCE: The home offers a service to older people with a range of learning disabilities. Through an agreed variation in its condition of registration, it also accommodates a person under 65. There have been no new residents admitted since the last inspection. There was documentation in place evidencing that assessments have been carried out for individuals by the appropriate funding authority. Staff on duty were able to relay in a clear way their duties and responsibilities and how they supported the residents. It was evident through discussion with staff that individuals are referred to specialist services for advice and support. Observation of records evidenced that this had been implemented following concerns by staff regarding the personal care support and safety of an individual. A requirement has been Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 9 made to follow up an assessment made by a specialist service in order to support this individual in a safe manner. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, & 10 The home has a care planning system in place to adequately provide both residents and staff with the information they need to satisfactorily meet individual needs The physical and emotional health needs of individuals are well met with evidence of multi disciplinary working taking place regularly. Those individuals who need support with personal care receive this support in the way they prefer and require in order to respect their privacy and dignity. EVIDENCE: The home is in the process of using new care planning documentation to record how individuals are supported with their appropriate care needs. Planning for life folders include personal details, daily records and routines, assessment of need and personal plans. Other areas include individuals’ aspirations, dreams, goals and choices. Reviews have taken place and the home is gradually transferring information to the new system. An individual’s records evidenced that their day care had been reviewed recently with a breakdown of the hours of support offered to them through the organisations day care team. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 11 It was evident through documentation that ongoing appropriate access to health care services and the promotion and maintenance of health of each resident continues. The home also continues to support residents with visits to GP, dentist, chiropody, and optician. Individuals’ psychological health also continues to be reviewed regularly as is their medication. It was evident during the inspection that an individual’s emotional needs have escalated recently; discussion with staff indicated that the home is in the process of following this up through a regular specialist service. A staff member related how an individual was supported with their personal care requirements. It was evident through discussion that their preferences are acknowledged and that through risk assessing their privacy is respected. Documentation identified that a requirement has been met to obtain advice from GP and consultant regarding personal epilepsy plans to include specific individual procedures to be followed as to when into a seizure. A risk assessment in place included how 2 individuals are supported; currently staff call emergency services following individual procedures. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 14 & 15 Staff support residents wishing to participate in differing activities and interests. Residents are encouraged in making choices regarding their lifestyle. Dietary needs of the residents are well catered for with a balanced and varied selection of food available. The home needs to record any alternatives offered. EVIDENCE: Discussion was had with a resident regarding aspects of their lifestyle. Both day care workers and staff at the home support them on a 1:1 basis with their recreational and social needs. It was evident that they are offered meaningful opportunities both externally and within the home. Another person attends a weekly cookery session and is also supported in accessing other activities through 1:1 support. One person is transported by the home to attend a day service 3 times a week. The vehicle used is their own, and is also used by the home for shopping and supporting other residents to access appointments and the community. There are written contracts in place setting out the arrangements for financial recompense. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 13 There is only one person who has no external day care support due to his health care needs and choices made by himself. Residents are supported with their financial affairs through the homes policies and procedures. Individuals have opportunities in making financial choices through shopping trips and holidays. The home follows a 4 week menu plan, although the set menu is flexible and may change due to differing activities and situations. The range of meals provided continues to be appropriate. It is evident that individuals are offered regular drinks and snacks during the course of the day. A resident related how they are supported with their diabetes and said differences in the choice of food are offered when appropriate. A staff member said that a resident sometimes did not respond to certain food offered. A requirement is made for a record to be kept of any alternatives offered evidencing that individuals’ preferences are taken into account. A resident laid the table for the midday snack. It was evident that this person enjoys helping out with household tasks and staff encourage their involvement. Two people are supported with their mealtime needs. Appropriate cutlery is provided and two specialist chairs for use at the dining table have been obtained. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 The home has appropriate procedures in place in order to respond to any complaints made. Staff have received training in the protection of individuals from possible risk of harm or abuse. EVIDENCE: There has been no change in that the home has a complaints policy stating action to take in response to a complaint within a specific time. No complaints have been recorded in the complaints log or received by CSCI since the previous inspection. It was evident through discussion with a resident that they are confident in raising any concerns and that they would be able to go to the manager with any issues. There are appropriate policies and procedures through The Brandon Trust for ensuring the protection of vulnerable adults. Staff attend Alerters level training on the protection of vulnerable adults through Bath and North East Somerset Social Services. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 The home presents a comfortable, clean and homely environment. EVIDENCE: The home is in keeping with the local community, and is near to local shops and amenities. There are bus services available for access to other local towns and to Bristol and Bath. The home provides a suitably furnished environment that meets the needs of individuals. An individual said their bedroom had been decorated and that they had been involved in choosing wallpaper and furniture. Specialist equipment such as sensory lighting and bed had been offered. The room was individualised through their personal possessions. They said they always locked their door and were responsible for keeping their own key. All areas of the house were clean, hygienic and odour-free. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 16 Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27 & 30 The staff team understand their role and responsibilities in order to meet the needs of residents. Staff are up to date with statutory training in order to carry out their responsibilities competently. EVIDENCE: A staff member related their duties and responsibilities showing how staff are monitored in carrying out tasks. There are clear instructions in place for staff to follow in relation to daily and weekly household tasks. Staff sign to indicate that they have completed tasks. There are currently 5 care staff employed at the home. There is one staff sleeping in; there are no waking night staff on duty. Through observation of the rota it was evident that bank staff have covered 56 hours during the previous month. Permanent staff are also asked to cover additional hours. Staff indicated that there is one regular bank staff that is used in order to provide consistency. Staff related that there can be difficulties in providing opportunities for residents to go out with those staff working at the home, when there are just two staff on duty. One staff member may be transporting an individual to access their day care or food shopping leaving one staff at the home. The individual physical needs of residents also prevent staff in taking people out due to two people needing wheelchair support. On balance, there was evidence that there were other arrangements for individuals to be supported to access Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 18 external opportunities during the week. This has been previously recorded in Standard 12. Staff training records identified that either all staff are up to date or are booked to attend statutory training. Both a requirement and recommendation have been met to update staff training records and set up a training matrix. The training matrix identified when staff had completed statutory training and when booked to update. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 19 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. 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 and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 & 38 The arrangements for the record keeping of the home has improved in order to safeguard individuals’ rights and best interests. There are procedures and protocols in place in order to ensure the health, safety and welfare of both service users and staff. EVIDENCE: As the manager was unavailable, it was not possible to examine the homes quality assurance monitoring through Standard 33. This will be a focus at the next inspection. A variety of differing records evidenced that there are arrangements in place to monitor individuals’ health, safety and welfare; these included menus and food safety, water temperatures, care plans including specific medical arrangements, rota and staff training records. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 20 The fire log was up to date with checks on all fire equipment. Records examined evidenced that all staff had attended regular fire drills and were booked to receive annual fire training. Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People 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 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X X 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x x 3 3 Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? YES 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 OP29 Regulation Sched 4.6 Requirement Ensure all staff records as set out in Schedule 4 are available for inspection in the home (This is a further requirement from the last inspection) Follow up assessment by specialist service in relation to showering equipment for a resident. Record alternative meals offered Timescale for action 31/07/06 2 OP3 14(1) 30/04/06 3 OP37 17(1) 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 Princess Close DS0000008176.V279901.R01.S.doc Version 5.1 Page 24 - 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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