Inspection on 17/06/05 for 20 Towngate East

This inspection was carried out on 17th June 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 no outstanding requirements from the previous inspection report, but made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

20 Towngate East 26/04/07

20 Towngate East 27/04/06

20 Towngate East 03/11/05

20 Towngate East 02/12/04

20 Towngate East 23/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 20 Towngate East Market Deeping Lincolnshire PE6 8DR Lead Inspector David Bacon Unannounced 17 June 2005 16:00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 20 Towngate East Address Market Deeping Lincolnshire PE6 8DR 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) 01778 342091 Mr N R Harris Mrs S Kitchen Care Home 7 Category(ies) of LD Learning Disability 7 registration, with number of places 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd December 2004 Brief Description of the Service: 20 Towngate East is located in the market town of Market Deeping in South Lincolnshire and within easy reach of local services and facilities. The home is registered to provide residential care for 7 adults having a learning disability. All bedrooms in the home are single and are situated on the ground and first floors. One bedroom has an en-suite facility. To the rear of the property there is a large garden, which is easily accessed by service users. There is no garden at the front of the property. The home has one main lounge area and a separate dining room. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place over 5 hours. A tour of the premises was conducted, care records, staff records and some maintenance records were inspected. Three service users representatives, two staff members and the acting manager were spoken with. What the service does well: What has improved since the last inspection? What they could do better: Service users and their representatives are not formally notified prior to admission where the home is able to meet an individuals care needs. The service users representatives spoken with said they had not been made aware of the homes policies, procedures or been given information regarding the homes facilities and services, including making a complaint. Also, provision must be in place to afford service users and their representative’s opportunities to express their views regarding the home. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 6 The care needs of each service user are not adequately met as specific equipment used for service users must be provided and adequately maintained. Care records should identify and document how service users life skills and personal development is promoted and met. Staff must receive statutory training and induction appropriate to meet the needs of service users. Although improvements are being made regarding the overall maintenance of the home the servicing of the fire system must be undertaken as per fire safety regulations. 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. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 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 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 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) 1, 2, 3, 4, 5 Procedures for the assessment and admission of service users to the care home are mostly being followed and service users representatives are satisfied overall with admission arrangements. However, service users and representatives are not fully aware of the homes facilities and services and they are not notified prior to admission where the home is able to meet each individuals care needs. EVIDENCE: 20 Towngate East has a service users guide and a statement of purpose, which detail the services provided by the home and its terms and conditions. These documents have recently been updated and are clearly and plainly written and made available to prospective service users. However, the service users representatives spoken with were not aware of these documents. Service users are issued with terms and conditions of occupancy. The service users records viewed do not fully document that service users had been notified that the care home was able to meet each individuals care needs. The acting manager said that service users are encouraged to visit the home prior to admission. The service users representatives spoken with were satisfied with admission arrangements. Comments included: “I don’t remember any problems with the admission process, they all seemed friendly enough, and caring”. “Yes the introduction was handled well by the staff, they 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 9 were interested and helpful”. “I’d been told that the staff were friendly and it was true, they were all very welcoming”. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 10 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 Improvements have been made regarding information written about service users, which mostly contain sufficient information to enable care staff to meet the care needs of service users during their stay. However, the home must document how each individual’s life skills and independence will be promoted and met. Also, records should fully evidence any involvement of service users or their representatives. EVIDENCE: A care plan is devised for each service user, which mostly identify the care needs of each individual although these do not fully identify how individual’s life skills and independence are to be promoted and met. A comprehensive risk assessment is undertaken for each resident, which clearly document risks and how these should be minimised. The acting manager said that care plans are reviewed each month and as changes occur although this was not fully documented and records inspected did not fully document that individual service users had been consulted regarding this. The service users representatives spoken with were positive about the care provided in the home and confirmed that residents are treated with respect 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 11 and supported to make decisions regarding their day to day lives, which was further evidenced within the care records inspected. Comments included: “When you visit you can see that choices are offered”. “The residents do choose what they do, where they can”. Information regarding this subject matter is provided to service users and displayed in the home. Staff members are initially made aware of the need to promote service users rights and choices as part of the induction process. During the visit staff were observed promoting service users choices and the staff spoken with were aware of individual likes and dislikes. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 12 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) 11, 13, 14, 15, 16, 17 A variety of activities are available for service users to participate in, which are enjoyed by the service users who are supported to maintain contacts with their family and the community. Service users needs, preferences and choices are respected and promoted as part of their daily living. EVIDENCE: The home has a mini-bus with tail lift enable service users to access community facilities. Records are maintained of activities and outings that residents had recently participated in and pictures are often taken to maintain a record and these are displayed in a album or within the home. The service users representatives spoken with said that there was a selection of activities provided. Comments included: “There are more things to do now, it has got better recently”. Representatives said that service users enjoyed the food provided and that foods were suitable for individual’s dietary needs, which was further evidenced 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 13 within the meal records viewed. Food safety checks are undertaken and records demonstrated that menus were varied and nutritionally balanced. Representatives comments included: “I don’t think there are any problems with the food, I’m sure its enjoyed”. “The food always seems fair, my loved one needs a special diet and this is now done”. Policies and procedures are in place to promote service users rights and choices and staff are made aware of these. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 14 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) 19, 21 The health needs of one service user are not fully being met although care records generally document the action taken following any advice or instruction given by other supporting healthcare services. Service users wishes regarding bereavement are respected but not fully documented. EVIDENCE: The service users representatives spoken with said they were satisfied that resident’s healthcare needs were met and that they were supported to maintain their independence wherever possible. The service users care records viewed further evidenced this. One service user was not having their health care needs fully met because their bed was not appropriate to meet their current care needs. It is acknowledged that the acting manager had taken some action regarding this. Throughout the visit staff were observed to ensure that service users dignity and privacy were maintained especially when personal care was carried out. Information regarding service users heath needs are recorded. Any specific requests regarding death arrangements are not fully recorded although the 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 15 acting manager said that policies and procedures are in place regarding this subject matter giving guidance to staff. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 16 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, 23 Systems are in place for dealing with complaints from service users and their representatives and regarding allegations of adult abuse although the service users representatives spoken with were not fully aware of these. Staff are made aware of the homes abuse and whistle blowing procedures. EVIDENCE: Complaints and abuse policies and procedures are in place for service users and provide guidance to staff although representatives spoken with were not aware of these. The representatives spoken with confirmed that they would feel confident complaining to staff if they had any concerns. Comments included: “You can talk with the staff, its reassuring to know that they are approachable”. “There have been problems previously with the care on occasion but they are listening more now”. “I have raised a couple of things with them and they have been fine but I’m not aware of any complaints procedure as such”. Information regarding advocacy services is displayed in the home. Staff demonstrated their awareness of adult protection procedures and there is evidence of training in regard to this subject matter. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 17 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) These standards were not inspected during this visit. EVIDENCE: 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 34, 35 There are sufficient numbers of staff overall to meet the needs of the service users, and staff mostly have the skills and experience necessary to carry out their roles although improvements are needed regarding staff induction and training. EVIDENCE: The staff files inspected evidenced that appropriate recruitment policies and procedures are in place prior to staff commencing work at the home. There have been no staff recruited since the previous inspection although the acting manager confirmed that induction training is not currently to sector skills council specification. The manager said that this was currently being updated. A training plan is in place although this has not recently been updated and training must be linked to the needs of service users and include: NVQ, epilepsy. Staff members confirmed that they now receive some formal supervision. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 19 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) 38, 39, 41, 42 Service users and staff benefit from an open and supportive management approach of the home although formal systems must be in place to measure the quality and satisfaction levels of the services provided. Fire safety systems are not fully maintained as per fire safety regulations. EVIDENCE: The acting manager said that service users and representatives views are sought on a daily basis and the representatives spoken confirmed this, which was further evidenced within the care records viewed. Service users representatives comments included: “The new manager is approachable and things seem to be getting better with staffing numbers”. “You can approach the manager, and all staff, there’s not a problem with this”. “It’s good because you can phone or call and they are all helpful and make you feel welcome”. Formal quality satisfaction systems have been devised but are not currently taking place. For example, service users/representatives meetings and quality satisfaction questionnaires. Confidentiality and access to records information is provided to service users. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 20 Health and safety policies and procedures are in place giving guidance to staff although the homes fire safety records did not demonstrate that the fire system had been fully tested as per fire safety regulations. 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 21 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 1 3 2 3 3 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 x 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 20 Towngate East Score x 2 x 2 Standard No 37 38 39 40 41 42 43 Score x 3 2 x x 2 x C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 22 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard 1 YA3 Regulation 4 (2) 14 (1) (d) Requirement Service users must be notified of the homes provision of facilities and services The regisered person must confirm in writing to the service user that the home can meet the care needs. It is required that a care plan is competed for each service user, which demonstrates how each individual is supported to develop life skills and independence. Service users healthcare must be maintained. Service Users and their representatives must be notified of complaint policies and procedures The registered person shall ensure that at all times suitably qualified competent and experienced persons are working at the home. Therefore, all staff must receive induction and attend training regarding NVQ and epilepsy awareness. The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as Timescale for action 01/10/05 01/10/05 3. YA6 15 01/10/05 4. 5. YA19 YA22 12 (1) 22 (5) 01/10/05 01/10/05 6. YA35 18 (1) and 19 01/10/05 7. YA42 23 (4) 01/10/05 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 23 8. YA39 24 9. YA21 4 possible eliminated. Therefore, it is required that the fire safety system is serviced as per fire safety regulations. The registered person shall establish and maintain a system for reviewing and improving the quality of care provided. Therefore, it is required that a formal system of reviewing the service provided is implemented and that service users and their representatives are involved where possible. Service users wishes regarding death must be documented. 01/10/05 01/10/05 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. Refer to Standard Good Practice Recommendations 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Unity House, The Point Weaver Road, off Whisby Road Lincoln LN6 3QN 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 20 Towngate East C53 C04 S2309 20 Towngate East V232301 170605 Stage 4.doc Version 1.30 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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!