Inspection on 03/11/05 for 20 Towngate East

This inspection was carried out on 3rd November 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 7 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 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 Unannounced Inspection 3rd November 2005 08:00 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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.V263533.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 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.V263533.R01.S.doc Version 5.0 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 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.V263533.R01.S.doc Version 5.0 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 17th June 2005 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 DS0000002309.V263533.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 4 hours and was unannounced. A tour of the premises was conducted, care records, staff records and some maintenance records were inspected. Two service users representatives were spoken with along with a District Nurse. What the service does well: What has improved since the last inspection? What they could do better: Care records should clearly document how service users care needs are met and that their life skills and personal development is promoted. Staff must receive statutory training to meet the needs of service users. The home is generally safe although a risk assessment of the premises must be undertaken. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 6 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.V263533.R01.S.doc Version 5.0 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.V263533.R01.S.doc Version 5.0 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, 4, 5, Satisfactory procedures overall are in place for the guidance of care staff in undertaking pre-admission assessments and the introduction of residents 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 clearly and plainly written and made available to prospective service users. Service users representatives are issued with terms and conditions of occupancy and a copy of these are maintained within the home. The service users representatives spoken with were satisfied with the homes admission arrangements. Comments included: “Oh, I remember that they were really very good and did what they could to help you”. “The staff were just as you would hope for, they put you at ease”. “It’s a long time ago but they gave me piece of mind immediately”. The care records viewed documented overall that each service users care needs had been assessed prior to admission although some risk assessment information was not available for inspection. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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 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. However, The home does not document how service users care needs are met or how each individual is actually supported to develop life skills and independence. EVIDENCE: The service users care records viewed identified the care needs of each individual but they did not detail how each individual’s life skills and independence were being promoted or met. For example, records of any activities/interests or personal development was limited and sporadic. Some care files were poorly organised and the layout was inconsistent. A comprehensive risk assessment was not in place for each service user. Care records were not reviewed as required and the records inspected did not fully document that individual service users had been consulted regarding this although some improvements have been made with this since the previous inspection. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 10 The service users representatives spoken with were positive about the care provided in the home and confirmed 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 do get a choice and I think this area has improved, there’s lots more going on recently and the residents are more involved”. “The residents do choose what they do, where they can”. “You can see that choices are offered”. Information regarding this subject matter is provided to service users and is an integral part of each service users care plan. 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. Care plans clearly detail how each service user expresses themselves and demonstrate that they are encouraged to make decisions for themselves wherever they are able. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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 A variety of activities are made available, which are enjoyed by the service users who are supported to maintain contacts with their family and the community although care records do not document these. Service users needs, preferences and choices are respected and promoted as part of their daily living. EVIDENCE: The service users representatives spoken with said that there was a selection of activities provided but these were generally not recorded although some pictorial records are maintained. Comments included: “When I visit now there are definitely more things going on, you know activities, you can see it and everyone seems to get involved”. “Its good to see that the residents are stimulated and they seem to enjoy and get benefit from the things they do”. 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.V263533.R01.S.doc Version 5.0 Page 12 Policies and procedures are in place to promote service users rights and choices and information regarding this is an integral part of each service users care plan. Staff are made aware of this subject matter as part of the induction programme. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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, 21 The health needs of service users are met, with good liaison with healthcare services Service users wishes regarding bereavement are respected but not fully documented. EVIDENCE: Information regarding any heath care needs of service users is maintained within their individual care plans. Any specific requests regarding death arrangements are not fully recorded, which was identified during the previous inspection. A District Nurse who visits the home confirmed that they had no concerns regarding the care provided and that the homes staff followed any given instruction or advice. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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 The home has policies and procedures in place for handling any complaints from service users and regarding allegations of adult abuse. Staff are made aware of the homes abuse and whistle blowing procedures. EVIDENCE: Policies and procedures regarding complaints and abuse are in place for service users and these provide guidance to staff who also attend abuse awareness training. Service users representative’s comments included: “If I had any concerns then I would talk them through with the manager or staff”. “I have talked to staff about concerns before now and things were dealt with.” Staff members were observed listening and appropriately responding to any views expressed by service users during the inspection. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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, 25, 26, 30 The standard of the physical environment is good and provides service users with a comfortable and homely place to stay. EVIDENCE: The home was clean and there were no unpleasant odours. Most of the communal areas were being repainted during the time of the inspection and service users and staff are in the process of choosing carpets for these areas. All furnishings are of a domestic nature and service users are supported to personalise their own accommodation. There is a patio and large garden to the rear of the property. Environmental risk assessments are in place and are reviewed at lest annually. All areas of the home are accessible to service users. The first floor area is accessed by stairs and also a stair lift of which service records are maintained. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 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 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): 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 further improvements are needed regarding staff training. EVIDENCE: The staff files inspected evidenced that appropriate recruitment policies and procedures are in place prior to staff commencing work at the home. Improvements have been made regarding the homes inducting of new staff, who now attend induction training to sector skills council specification. A training plan is in place although this is not fully updated and training must be linked to the needs of service users and include: epilepsy awareness. This was initially identified during the previous inspection. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 17 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): 39, 40, 42 Systems are partially in place to measure the quality and satisfaction levels of the services provided and comprehensive policies and procedures are in place to safeguard service users rights. 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 service users. Service users meetings are held and a new system has been introduced to further seek service users and representatives views regarding the service provided although records of this were not available. Quality satisfaction questionnaires are not used. 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 of a risk assessment having been undertaken for the physical environment. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 18 The homes fire safety records were satisfactory and COSHH data sheets were maintained. Maintenance records for the building and equipment are also maintained. 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 19 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 3 2 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 3 2 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X X X 3 LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X 3 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 20 Towngate East Score 3 3 X 2 Standard No 37 38 39 40 41 42 43 Score X X 2 3 X 2 X DS0000002309.V263533.R01.S.doc Version 5.0 Page 20 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). Care plan information must document the care provided and how each individual is supported to develop life skills and independence (previous timescale 01/10/05 not met). A comprehensive risk assessment must be undertaken for each service user. Service users wishes regarding death must be documented (previous timescale 01/10/05 not met). 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 epilepsy awareness (previous timescale 01/10/05 not met). The registered person shall establish and maintain a system for reviewing and improving the DS0000002309.V263533.R01.S.doc Timescale for action 01/12/05 2 YA6 15 01/12/05 3 4 YA9 YA21 13 (4) (c) 4 01/12/05 01/10/05 5 YA35 18 (1) 19 01/02/06 6 YA39 24 01/02/06 20 Towngate East Version 5.0 Page 21 7 YA42 13 (4) 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 is undertaken. 01/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 20 Towngate East DS0000002309.V263533.R01.S.doc Version 5.0 Page 22 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.V263533.R01.S.doc Version 5.0 Page 23 - 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!