Inspection on 27/04/06 for 20 Towngate East

This inspection was carried out on 27th April 2006.

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 03/11/05

20 Towngate East 17/06/05

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 Mr David Bacon Key Unannounced Inspection 27th April 2006 08:30 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 20 Towngate East DS0000002309.V289941.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 20 Towngate East Address Market Deeping Lincolnshire PE6 8DR 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) 01778 342091 jodawson75@msn.com londonroad@tiscali.co.uk Milbury Care Services Limited Miss Joanne Lesley Dawson Care Home 7 Category(ies) of Learning disability (7) registration, with number of places 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered to provide personal care for service users of both sexes whose primary needs fall within the following categories: Learning Disability (LD) - 7 places The maximum number of service users to be accommodated is 7. Date of last inspection 3rd November 2005 Brief Description of the Service: 20 Towngate East is situated 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 lawned garden, which is easily accessed by service users. There is no garden to the front of the property. The home has one main lounge area and a separate dining room. 20 Towngate East DS0000002309.V289941.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 hours; it was unannounced and was carried out by one inspector. A tour of the premises was conducted, service users care records and staff records were inspected. Also, completed care homes surveys were received from seven service users. The inspector spoke with two service users representatives, the manager of the home and one staff member. The homes fees range from £779.90 to £1’230 per week. What the service does well: What has improved since the last inspection? The physical environment continues to improve. For example, a new laundry area has recently been created within an outbuilding, which is more easily utilised by service users. Some improvements are being made with service user and staff recording systems although these are still not well managed overall and some further improvements are needed. However, service users care records more clearly document how service users care needs are met and how their life skills and personal development is promoted. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 6 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. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 1, 2, 3, 5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Satisfactory procedures overall are in place for the introduction of service users to the home. EVIDENCE: A service users guide and statement of purpose are in place, which detail the services provided by the home and its terms and conditions. These documents are presented in a simple format, which utilise pictures where possible and are provided to prospective service users. Service users care needs are assessed prior to admission and this information is recorded to form an individual care plan. Service users or their representatives are involved in the devising of this where possible. Service users are issued with terms and conditions of occupancy and a copy of these are maintained within their personal file. The service users representatives spoken with were satisfied with the homes admission arrangements. The information received in the completed care homes surveys received indicated that service users were satisfied with the homes admission process. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 6, 7, 8, 9, 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a person centred approach to the care they receive, which enables them to develop their independence in a safe and supported manner. EVIDENCE: The service users representatives spoken with said that residents are treated with respect and supported to make decisions regarding their day to day lives, which was further evidenced within the care records inspected. Comments included: “The residents have a choice wherever possible, it’s very good”. “They treat the residents very well, the staff work hard with this”. “The staff are respectful and caring”. The information received in the completed care homes surveys received indicated that service users were satisfied overall with the homes standards of care. Staff members are initially made aware of the need to promote service users rights and choices as part of the induction process. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 10 Some improvements have been made with care recording systems since the previous inspection as records demonstrated how each individual’s life skills and independence were being promoted. The service users files inspected contained information regarding promoting service users rights, confidentiality and data protection. The care records viewed clearly identified the care needs of each service user and how these were to be met along with any identified risks and how these were to be minimised. Care records were reviewed every 6 months and documented where service users had been consulted with regarding their plan. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users who are supported to maintain contacts with their family and the community although the homes recreational provisions are not adequately documented. Service users needs, preferences and choices are respected and promoted as part of their daily living. EVIDENCE: Service users individual dietary preferences and needs are recorded and a variety of meals are provided although these are not adequately documented. Service users recreational preferences are documented in their care plans and the service users representatives spoken with said that there was a variety of activities provided although these were not generally recorded. Comments included: “There seems to be lots available to do”. “There’s plenty, a good variety, it’s good to know that they all are involved in the local community”. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 12 Individual plans detailed how service users rights and choices were to be promoted. The information received in the completed care homes surveys received indicated that service users were satisfied overall with the homes provision of activities and meals. The home has a mini-bus with tail lift enable service users to access community facilities of which service users contribute to fuel. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 18, 19, 20, 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The health needs of service users are met, with good liaison with healthcare services. Service users wishes regarding the care they receive is promoted. EVIDENCE: The overall care needs of each service user is documented within their individual care plans, which include information regarding any known preferences and an insight as to each individuals personalities and emotional wellbeing. Any specific requests regarding death arrangements are not fully recorded. Medication policies and procedures are in place and staff administering medication receive awareness training regarding this. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Systems are in place for handling any complaints about the service and to help safeguard service users from abuse. Staff are made aware of the homes abuse and whistle blowing procedures. EVIDENCE: Complaints and adult protection policies and procedures are in place for service users, which provide guidance to staff who also attend abuse awareness training. Service users representative’s comments included: “I don’t want to complain but I would do if necessary and am sure they would deal properly with it”. “The staff would want to put things right if there was a problem”. “I have got no complaints and know how to”. The information received in the completed care homes surveys received indicated overall that service users knew how to complain. The staff member spoken with was aware of the correct action needed to be taken in the event of an issue of abuse being raised. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 the following standard(s): 24, 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The standard of the physical environment is good and provides service users with a comfortable and homely place to stay although the home must be fully maintained. EVIDENCE: The home was clean, tidy and there were no unpleasant odours. Most of the communal areas have recently been repainted and new carpets are being fitted for these areas. All furnishings are of a domestic nature and service users are supported to personalise their own accommodation. The information received in the completed care homes surveys received indicated that service users were satisfied with the physical state of the premises. There is a patio and large garden to the rear of the property and all areas of the home are accessible to service users. The first floor area is accessed by stairs and also a stair lift. The homes environmental risk assessments were not available for inspection. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 16 Some equipment service records were not available for inspection. For example, regarding electrical safety and the stair lift. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. There are sufficient numbers of staff overall to meet the needs of the service users, and staff overall have the skills and experience necessary to carry out their roles although further improvements are needed regarding staff training. EVIDENCE: The information received in the completed care homes surveys received indicated that service users felt that there were sufficient numbers of staff. The staff files inspected evidenced that appropriate recruitment policies and procedures are undertaken prior to staff commencing work at the home. Newly recruited staff attend induction training to sector skills council specification. A training plan is in place although this remains partially updated and training must be linked to the needs of service users and include: epilepsy awareness for all care staff and national vocational training. It is acknowledged that some action has been taken regarding this. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 37, 39, and 42 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, 39, 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users rights are promoted and safeguarded. Some systems are in place to measure the quality and satisfaction levels of the services provided although further improvements are needed to be made regarding this. Fire safety systems are fully maintained as per fire safety regulations. EVIDENCE: Policies and procedures have been devised to safeguard service users rights and information regarding this is provided to them. Service users meetings are not regularly held and although a new system has been introduced to further seek service users and representative’s views regarding the service provided this was not fully available for inspection. Quality satisfaction questionnaires are not regularly used. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 19 Systems are in place to promote health and safety within the home and staff attend training regarding this subject matter. However, there were no records available of a risk assessment having been undertaken of the physical environment. 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 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 Standard No Score 1 3 2 3 3 2 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 3 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 2 15 3 16 3 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 2 X X 2 X 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 21 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 YA3 Regulation 14 (1) (d) Requirement The registered person must confirm in writing to the service user that the home can meet the individuals care needs (previous timescale 01/10/05 not met). The registered person shall prepare a plan as to how the service users needs in respect of health and welfare are to be met. Therefore, it is required that care records demonstrate fully how the daily living and recreational needs of service users are met. The home must demonstrate the variety and choice of foods made available to service users. Confirmation is required detailing what action is being taken to ensure that sufficient numbers of staff receive NVQ training. The registered person shall ensure that at all times suitably qualified competent and experienced persons are working at the home. Therefore, all staff must attend training regarding epilepsy awareness (previous timescale 01/10/05 not met). Timescale for action 30/06/06 2 YA14 15 16 (2) (n) 30/06/06 3 4 YA17 YA32 16 (2) (i) 18 (1) 30/06/06 30/06/06 5 YA35 18 (1) and 19 30/06/06 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 22 6 YA39 24 7 YA42 13 (4) 8 YA42 16(2)j 23(2)p 13(3)4 a 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 (previous timescale 01/10/05 not met). The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. Therefore, a risk assessment of the premises must be undertaken (previous timescale 01/12/05 not met). The registered person shall ensure that unnecessary risks to the health and safety of service users are identified and so far as possible eliminated. Therefore, confirmation is required to be sent to the CSCI detailing what steps are being taken to prevent risks from legionella. This is to include a risk assessment regarding the maintenance of water systems. Also, confirmation is required of the home having a valid electrical safety certificate and regarding the servicing of the homes stair lift. 30/06/06 30/06/06 30/06/06 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 Good Practice Recommendations DS0000002309.V289941.R01.S.doc Version 5.1 Page 23 20 Towngate East Standard 20 Towngate East DS0000002309.V289941.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office 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 DS0000002309.V289941.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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