Inspection on 26/09/05 for 2 Princess Close

This inspection was carried out on 26th September 2005.

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

The inspector 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 11/01/06

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 26th September 2005 09:30 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.V259949.R01.S.doc Version 5.0 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.V259949.R01.S.doc Version 5.0 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.V259949.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd March 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 a bathroom with 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.V259949.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5.5 hours and was carried out as an unannounced inspection. The one requirement made remains unmet and is still being dealt with on a higher level between the Commission for Social Care Inspection and The Brandon Trust. The recommendation has been partly met and is still in the process of being reviewed. The inspection methods used included record and documentation checks, case tracking, and discussion with 2 staff, the manager and all five of the residents. What the service does well: What has improved since the last inspection? What they could do better: Requirements 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) Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 6 Obtain advice from GP and consultant regarding personal epilepsy plans to include specific individual procedures to be followed as to when into a seizure. Set out an action plan in order to demonstrate that the outcome by other means of training for a staff member meet with that of a National Vocational Qualification; include how the home will monitor their development and how the manager will evidence their competence. Update staff training records Keep a consistent record of staff attending fire drills Recommendations The manager to attend Investigators training for the Protection of Vulnerable Adults. Set up training needs matrix 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.V259949.R01.S.doc Version 5.0 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.V259949.R01.S.doc Version 5.0 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): 2, & 4 The home provides residents with a written contract. The assessed needs and preferences of residents are met and there are processes in place for the review of their care. EVIDENCE: The last resident to be admitted to the home who moved from another service run by the Brandon Trust has completed their trial period. All appropriate assessment processes were evidenced through relevant information having been transferred. The Brandon Trust are currently carrying out a quality audit on 3 people, one of whom is a resident at Princess Close. The information being collated from the home is in relation to the admission of this resident, the choices they made and the appropriateness of the placement. It was evident through documentation and discussion with the manager that discussion is still continuing with both the family and the funding authority regarding the individuals health needs. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 9 A planned visit by the RNIB in order in order to carry out an assessment of the home’s environment for individual with a visual impairment has taken place. Grab rails have been placed in specific areas to enable independence for the individual with their mobility. A restriction in place for another resident in the form of a safety gate across their first floor bedroom door for use only during the night continues to be monitored and reviewed on a regular basis. It was evident that this person’s care continues to be reviewed on an ongoing basis in order that any changing needs are identified and that the home can continue to offer an appropriate service. There is a stairlift in place to support the majority of the residents in accessing the first floor. A written contract is in place stating terms and conditions of their accommodation. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 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, & 9 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. The home needs to improve in the recording of specific medication required in order to protect an individual from risk. EVIDENCE: Current care planning has been maintained and reviewed whilst the process of setting up Personal Plan folders with condensed information from the previous Planning for Life folders continues. The transferring documentation covers risk assessments (which have also been reviewed), individual procedures likes and dislikes, and any agreed intervention. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 11 The home continues to support residents with their health care needs through visits to GP, dentist, chiropody, and optician. Annual health checks take place. One resident is being weighed on a regular basis following the advice by a specialist service. There have been recent changes in this person’s health that the home is monitoring. The home has notified the Commission of these changes through Regulation 37 reports. The manager said she would refer individuals to the Community Learning Difficulty Team if there was a need for support from specialist services. This was evidenced through documentation. Individuals’ psychological health continues to be reviewed regularly as is their medication. An individual spoke highly of a specialist service involved in their care and that they felt they were listened to. It was evident that the home responds appropriately to health care issues and has involved the emergency services on 5 occasions since the last inspection. Risk assessments were in place identifying those service users who are at risk of falling. The home has a medication policy. Medication is kept secure. The records showed that on going and daily medication was administered appropriately and was consistent with those held. It was evident through discussion with the manager and observation of documentation that a resident requiring a specific medication for epilepsy had no personal epilepsy plan in place. This document should set out agreed steps in consultation with GP and consultant/appropriate clinical specialist to be taken in the event of a seizure. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 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, 13, & 15 Staff support individuals wishing to participate in differing activities and interests. Residents are supported in maintaining contact with their families. Dietary needs of the residents are well catered for with a balanced and varied selection of food available. EVIDENCE: A resident said they were unhappy with some of their day care support not taking place. The manager said this was due to day staff vacancies within the agency. However records indicted that residents are still being offered opportunities to access the local community by the home and a weekly activity list evidenced this. Two individuals identified and chose an appropriate holiday to suit their needs and preferences. A visitors’ policy is in place. Arrangements continue in maintaining contact with residents’ relatives. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 13 A record is kept of all individual meals and any alternative choices provided. The range of meals provided continues to be appropriate. The menus were observed to offer wholesome and nutritious food. The manager said preparation of meals were a priority for residents. A resident was observed preparing their midday meal with support from staff. It was evident they made choices on a daily basis. Two people are supported with their meal-time needs. Appropriate cutlery is provided and two specialist chairs for use at the dining table have been obtained. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 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: 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. The manager indicated that individuals have made complaints in the past. Staff have attended Alerters level training on the protection of vulnerable adults through Bath and North East Somerset Social Services. Discussion was had with the manager the benefit from her attending the Investigators training also provided by Bath and North East Somerset. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 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): 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. All areas of the house were clean, hygienic and odour-free. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 16 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, 28, & 30 The home has an effective staff team supporting the needs of individuals. The home needs to set an action plan for those staff not registering with a national qualification in order to ensure the competency of staff is monitored. Staff are up to date with statutory training in order to carry out their responsibilities competently. EVIDENCE: The home continues to has a staffing establishment of 7fte staff. There are currently 5 care staff in place leaving 52.5 hours vacant per week; these are covered through existing staff on a bank basis and very occasionally via other bank staff. The manager indicated that following a recent recruitment drive, a potential applicant has shown interest in working at the home. The rota continues to be structured for two staff to be on duty during the day; one staff member carries out sleeping in duties. Two staff members spoken with related their previous experience of which has been in the learning disability field. They were clear about their role and responsibilities within the home. A handover period allows staff time to record duties completed and informs the new shift of any significant information. Staff meetings take place where both ideas and individual goals for stimulating individuals are discussed. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 17 A staff member has a National Vocational Qualification Level 3, whilst two others are in the process of completing level 2. A fourth staff member has a recognised qualification whilst the remaining staff member is not be registered. The manager will need to demonstrate that the outcome by other means of training for this person meet with that of a National Vocational Qualification. Also how the home will monitor their development and how the manager will evidence their competence. It was evident through discussion with the manager and observation of documentation that training records are in need of being updated. Information was sent to the Commission at a later date that staff had completed updates in both first aid and manual handling. Other areas of statutory training were up to date. Discussion was had with the manager in relation to setting up a training matrix in order to identify training needs. Those areas documented regarding training attended included participation in respect of both advocacy and racial awareness. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 18 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): 36, 37, & 38 Staff receive regular supervision. The home’s record keeping needs to improve in order to monitor practices consistently. EVIDENCE: Staff spoken to indicated they receive regular supervision from the manager. It has also been noted through Regulation 26 visits that this is an area that is monitored. Specific comments about records examined are detailed in the relevant sections of this report. One area of recording that is in need of improvement is related to staff training (see Standard 30). Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 19 The home complies with informing Commission for Social Care Inspection in respect of accidents and incidents occurring in the home. The fire log was up to date with checks on all fire equipment. However it was unclear as to whether all staff had attended regular fire drills. Again this area needs to be recorded on a consistent basis. Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 20 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 3 x 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 x x x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x x x x 3 2 3 Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 21 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 19(1) Schedule 4.6 19(1) Regulation OP29 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) Obtain advice from GP and consultant regarding personal epilepsy plans to include specific individual procedures to be followed as to when into a seizure. Set out an action plan in order to demonstrate that the outcome by other means of training for a staff member meet with that of a National Vocational Qualification; include how the home will monitor their development and how the manager will evidence their competence. Update staff training records Keep a consistent record of staff attending fire drills Timescale for action 31/12/05 2 OP9 30/11/05 3 18(1)(c) OP30 31/01/06 4 5 Schedule 4(6)(f) Schedule 4 (14) OP37 OP38 31/12/05 31/10/05 Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard 18 30 Good Practice Recommendations The manager to attend Investigators training for the Protection of Vulnerable Adults. Set up training needs matrix Princess Close DS0000008176.V259949.R01.S.doc Version 5.0 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. 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