Inspection on 20/07/05 for Warwick Road, 4

This inspection was carried out on 20th July 2005.

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

Warwick Road, 4 20/10/09

Warwick Road, 4 19/09/07

Warwick Road, 4 31/07/06

Warwick Road, 4 28/11/05

Warwick Road, 4 16/02/05

Warwick Road, 4 04/08/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 4 Warwick Road Wallsend Tyne & Wear NE28 6RT Lead Inspector Deborah Haugh Unannounced 20 July 2005 09:30 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. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 4 Warwick Road Address Wallsend Tyne & Wear NE28 6RT 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) 0191 234 4655 n/a n/a Northern Life Care Limited vacant CRH 4 Category(ies) of LD Learning Disability (4) registration, with number of places 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 16/2/05 Brief Description of the Service: The home is registered to provide care for four adults with learning disabilities who may also have physical disabilities. The home does not provide nursing care. The home was purpose built in recent years and provides homely ground floor accommodation. It is situated in the centre of Wallsend and therefore close to all local amenities. It is immediately adjacent to No 2 Warwick Road which provides a similar service. Both homes are run by a private company, Northern Life Care, now known UBU, which also provides services in other parts of the country. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 20/7/05, between 9.30am and 2.30pm. The proposed Manager was on duty during the visit and has been in post for 3 months. Staffing levels were as agreed previously with the local authority inspection unit. Time was spent looking around the home to check the cleanliness, maintenance and decoration. The service users are unable to express their views about the home and at the time of the visit there were no visitors. Time was also spent observing the contact between the service users and staff. Two Care Plans for service users were examined. Staff described their approaches to caring for the service users. Training was discussed with the Manager. Arrangements for the administration and management of medication were audited. Good progress is being made to address the serious concerns raised at the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Staffing levels at the home are being increased by UBU to cover busy periods. The needs of the service users are changing and staffing must be adequate to continue to meet their needs. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 6 The previous management and care provided has caused major concerns and the new Manager is committed to improving standards. The Manager’s management hours must reflect the current concerns and UBU’s commitment to bring about change in the home. The premises was clean and well maintained but some areas must be addressed. 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. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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) 5 The home identifies the needs and aspirations of service users and the reviewed contracts will continue to protect service users. EVIDENCE: Two service user care plans were examined. Contracts are in place and are being reviewed by the Council and UBU. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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) 6,7,9 & 10 Care plans are detailed and identify the needs of the service users and actions to meet them. Risk assessments provide guidance to staff and protect service users, but one area requires assessment. Confidential information is secure but could improve in one area. EVIDENCE: Two care plans were examined. Staff discussed their approaches to caring for the service users and interactions between service users and staff were observed. Care plans are comprehensive and look at a full range of needs of the service users. They include information on the support package from the organisation and other agencies. Staff must consistently record that they have read and understood the care plan interventions. Communication with the service users is complex and the various methods developed by the staff are identified. Targetted ambitions are identified each year so that new activities and experiences are introduced. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 10 The care plans are evaluated on a regular basis and reviews are carried out. Old care plans should be archived to prevent confusion. Limitations of choice to safeguard the service users are fully recorded. Risk assessments cover aspects of the service users’ lives but access to the kitchen should be assessed (see NMS 42). The Manager is working hard to address the concerns regarding care plans, health care and risk assessments. According to the Manager the B4A form regarding service users finances contains details of total account balances which is not required to be seen by all staff. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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) 13 & 17 Service users have access to a variety of activities both inside and outside of the home. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users dietary needs and tastes. EVIDENCE: Service users are supported to participate in the local community, for instance, visiting places of interest, swimming and discos. Staff have now received training in the use of an electric wheelchair so access to the local community with one service user is easier, although staff said the environment in Wallsend is not always easy to navigate. The home has a 3- week menu plan. A dietician has provided advice and checked the menus for their nutritional content. Advice is sought from eating and swallowing professionals. Appropriate food is in stock and the dietary needs of the service users are being met and monitored. Care plans detail any dietary needs and interventions. Excellent progress has been made by the home with support from other professionals. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 12 Breakfast and snack time was unhurried but busy for the carer. Fresh fruit was being offered. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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 - 20 The health needs of residents are being met with multi disciplinary working taking place on a regular basis. The medication at this home is being managed but some areas need improving. EVIDENCE: The staff monitor service users health needs which are recorded in the care plans. Good improvements have been made since the last inspection. Routine health checks are carried out and service users attend appointments with relevant health care professionals with staff. Advice is sought from professionals and care plans reflect this. Medication arrangements have improved and a new monitored dosage system is in place. Staff have received basic Boots training on the new system but accredited training has been applied for. Some areas still require improvement. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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 Complaints are dealt with appropriately. EVIDENCE: Complaint recording systems are available to staff and for inspection. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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, 29 & 30 The areas inspected in the home were clean and safe but some areas require maintenance. EVIDENCE: The home has been decorated but some areas require repair. One bedroom has marks on the wall against the bed. The shower room has a damp patch due to problems with a roof leak. This is due to be repaired. The shower radiator is rusty. The corridor carpet is rucked and bleach stained. Bedrooms are homely and personalised. Occupational Therapists have reassessed equipment used by the service users. Infection control measures are in place with paper towels and hot water in bathrooms and showers. Antibacterial products must be available and used as per pressure management care plan. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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) 33 & 35 Staffing levels are as agreed previously with the local authority inspection unit but must be reviewed to reflect the changing needs of the service users. Staff are receiving training which will improve the level of care to service users. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority. However the current levels of staffing which are a minimum of 2 care staff on duty during the day and 1 waking night staff with 1 person sleeping in are to increase. From 1/8/05 the staffing levels will increase to 3 care staff on duty between the hours of 10am and 6pm and at busy times. During the inspection the Manager and one carer who were the staff on duty struggled to deal with the needs of the service users as well as the day- today management of the home. One service user required emotional support 1:1 and 2 other service users require 1:1 supervision for personal care such as 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 17 feeding. The other service user received little stimulation due to the immediate needs of the others. The levels of staff must be kept under review by the Registered Provider UBU and the Manager so that they reflect the continuing and changing needs of the service users such as ageing, emotional and safety support Training in response to requirements and development have and are being provided by UBU. Courses include: Tissue viability, eating and swallowing, medication, continence management, rectal diazepam, protection of vulnerable adults, communication, challenging behaviour, risk assessment, menu planning and mandatory health and safety training. Progress will be reviewed at the next inspection. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 18 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, 39 42 The home is not being managed effectively to safeguard residents and to fulfil their potential. EVIDENCE: The new Manager has been in post for 3 months and is committed to improving the quality of life for service users. No 4 Warwick Road had, and continues to have, problems regarding the staffing, training, culture and care. The Manager currently works 20 hours as a carer and has 20 hours for management tasks. Due to the depth of work that this required to bring the home back up to standard the new Manager must be given the time to do this and develop into the role himself. The Manager’s hours must become exclusively management tasks and this will be reviewed in December 2005. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 19 UBU and the Manager have quality assurance systems in place. Staffing levels must be kept under review (see NMS 33 and Requirements) Requirements made at the last inspection have been addressed. A risk assessment must be completed concerning the kitchen access which reflects the service users potential for being in the kitchen without staff knowledge. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 20 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x 3 2 Standard No 11 12 13 14 15 16 17 x x 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 1 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 4 Warwick Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 1 x 2 x x x 2 B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 21 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. Standard 6 Regulation 15 Requirement Staff must record that they have read and understood the care plan interventions (eg dietary requirements) Medication issues must be addressed;1. Creams must be dated when opened. 2. Creams must be locked away OUTSTANDING Feb 2005. 3. Multiple use of opened creams must cease. The identified bedroom wall must be repainted, the rusty shower radiator must be repainted or replaced. The stained and rucked corridor carpet must be repaired or replaced. Anti-bacterial products must be available and used as per pressure management care plan. The levels of staff must be kept under review by the Registered Provider UBU and the Manager so that they reflect the continuing and changing needs of the service users such as ageing, emotional and safety support The manager’s hours must become supernumary and reviewed in December 2005. Timescale for action 1/8/05 2. 20 13(2) 25/7/05 3. 24 23(2) 30/9/05 4. 5. 30 33 & 39 16(2) 18 21/7/05 30/9/05 6. 37 10 1/8/05 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 22 7. 9 & 43 13(4) A risk assessment must be completed concerning the kitchen access which reflects the service users potential for being in the kitchen without staff knowledge. 25/7/05 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 6 10 Good Practice Recommendations Archive unused care plans Review content of Form B4A so that access to information is strictly on a need to know basis. 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 Page 23 Commission for Social Care Inspection Northumbria Houe Manor Walks, Cramlington Northumberland NE23 6UR 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 4 Warwick Road B53-B03 S358 4 Warwick Road V233333 200705 Stage 4.doc Version 1.30 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. 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