Inspection on 31/08/05 for 218 Kingsway

This inspection was carried out on 31st August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

218 Kingsway 14/11/07

218 Kingsway 03/10/06

218 Kingsway 21/02/06

218 Kingsway 25/02/05

218 Kingsway 03/06/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 218 Kingsway St George Bristol BS5 8NS Lead Inspector Sandra Jones Unannounced 31st August 2005 9:30 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. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 218 Kingsway Address St George Bristol BS5 8NS 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) 0117 9476315 0117 9709301 Aspects & Milestones Trust Ms Nicola Josefowicz CRH-PC PC care home only 5 Category(ies) of MD Mental Disorder (5) registration, with number of places 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate up to 5 persons aged between 18 and 64 years with Mental Disorder. Date of last inspection 25 February 2005 Brief Description of the Service: 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was conducted on an unannounced basis over one day. There have been no additional visits to the home since the last inspection. There were three residents at the home during the inspection and one person refused to give feedback. One relative at the home was consulted on the standards of care observed during their visit. What the service does well: What has improved since the last inspection? 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. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 6 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 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 7 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) These standards were not examined at this inspection. EVIDENCE: 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 8 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 planning is beginning to be based on a person-centred approach to meeting needs. Residents are enabled to make some decisions about their lives. Risk assessments must be completed for all restrictions imposed at the home and they must reflect the level of risk involved . The Confidentiality policy is based on the expectations and arrangements for maintaining records at the home. EVIDENCE: Annual Care Plan Approach (CPA) reviews have taken place with the residents, staff and where appropriate, relatives. From the enhanced level care plans the home’s care plans are being updated. A more person-centred approach is being used to compile personal profiles and care plans. Personal profiles and care plans include the person’s preferred routines and likes. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 9 In terms of the aims of the care plan, the approach centres on the manner in which the person’s needs are to be met by the staff, indicating that the person has contributed to the planning of their care provision and agreed to the action plan. However, a number of care plans require updating. Documentation in case records indicates that residents can make decisions about all aspects of their care. From the documentation it is evident that during CPA reviews residents are involved in decision-making. For example, about their medication administration. Risk assessments can be used to empower residents to undertake activities that contain an element of risk. As evidenced for one resident that chooses to leave the home without staff support. Restrictions are imposed at the home and are based on locking bedroom doors at night; for one resident drinks are limited; and on smoking for two residents. Records suggest that one person has restrictions imposed to improve behaviours exhibited. It is acknowledged that this assessment is scheduled for reviewing, however, the format used is negative. Risk assessments on locking bedroom doors and smoking must be developed and the actions to reduce the risk must be consistent with the level of assessed risk. Reports of significant events suggest that at times some staff use the records to express their feelings, while others use a maternal approach. The content is not always respectful to the person and does not take into account residents’ past histories and age. During the inspection it transpired that drinking mugs are kept locked because when residents have full access to the mugs, the dishwasher is always full of mugs. Residents were observed using the same mugs without washing them. Whilst it is irritating having to consistently put the dishwasher on, this practice is for the convenience of the staff. The Aspects and Milestones policy manual includes the Confidentiality policy. It confirms the expectations for sharing information, storage and access. In terms of storage and access of information, the policy states that local arrangements must be made. A local policy describing the arrangements is in place. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 10 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, 14, 15 & 16 Residents have a meaningful part in the local community; they participate in local events and visit local shops and amenities independently or with the support of the staff. Keyworkers have specific time with their key residents Relative at the home during the inspection confirmed that visitors to the home are welcome. It is part of the culture that residents participate in household chores. EVIDENCE: A relative visiting the home agreed to feedback on the standards of care they have observed at the home. It was reported that the environment is always clean and tidy, and staff are always helpful. From experience the relative stated that staff keep relatives informed and the level of care provided ensures that residents’ needs are met. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 11 The visitors’ notice stipulates that there are no restrictions on visiting and for a small charge refreshments and meals can be provided on request. A relative visiting the home confirmed the arrangements in place for visitors. It was further reported that friends and relatives can have visitors in shared space or bedrooms. Currently one resident requires the support of the staff to leave the home for shopping trips and GP visits. It was understood from staff that residents support local events, forums and Trust activities. Residents currently attend college courses, day care centres and employment. Leisure activities are arranged on an individual basis or small groups that share the same interests. These include meals out, bowling, cinema and holidays. Four residents are going away at the weekend, two are going to Blackpool and the other two will be going to Bournemouth with their keyworkers. It is part of the ethos of the home that residents participate in household chores. The home is divided into sections and residents are given responsibility for these areas. Each person has a house day to clean their bedroom and do their washing, with daily chores. It was understood from a member of staff that if residents request them, changes in household chores will occur. Front door and bedroom keys are provided and residents reported that they can lock their door when they are in their bedrooms. Smoking is permitted in designated areas and for staff that smoke it is restricted to the garden only. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 12 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) These standards were not examined at this inspection. EVIDENCE: 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 13 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 Residents and relatives feel that their views are sought and acted upon. EVIDENCE: There were no complaints received at the home and CSCI for investigation since the last inspection. Residents and representatives consulted reported that members of staff can be approached with complaints. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 14 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 examined at this inspection. EVIDENCE: 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 15 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) 32 & 33 The home operates above NMS of 50 staff qualified in NVQ level 2. Staffing levels currently meet the needs of the residents and systems in place support consistency of care at the home. EVIDENCE: Three staff have completed NVQ level 3 and two are undertaking this training, with the manager undertaking NVQ level4. By having the six staff undertaking vocational qualification, the home will be operating above NMS of 50 qualified in NVQ level2. The rota in place indicates that one person is rostered to work throughout the day. The member of staff on duty confirmed that with one exception, staff undertake a combination of day and night duty. It was reported that individual supervision, diaries, handovers and team meetings are the systems used to maintain consistency of care. Staff meetings are arranged 4-6 weekly and provide opportunities for staff to make suggestions. These are complemented by occasional team building days. Staff receive study days, statutory training and other specific training. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 16 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) 41 The records that relate to fire safety and cash held in safekeeping were examined and found to be accurate and up to date. EVIDENCE: The home is aware of their responsibilities towards Regulation 37. Reports that relate to Regulation 26 visits conducted by the external manager are forwarded to the CSCI office. The records that relate to fire safety policies, procedures, checks and practices were examined. From the records it is evident that checks and practices are conducted at the stipulated frequencies. Facilities for the safekeeping of cash and valuables exist at the home. During the inspection the staff were observed checking the balances for handover. 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 17 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 x 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 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 x x 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 218 Kingsway Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x 3 x x D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 18 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 Standard 6 Standard 9 Regulation Requirement Timescale for action 30.12.05 30.12.05 3. 4. Standard 9 Regulation A person-centered approach 12 (2) must be used to develop care plans. Regulation Risk assessments must be 13(4) (b) completed for a) locking the bedroom doors at night, b) smoking, c) limiting access to the mugs. The actions must be consistent with the level of risk identified. Regulation Reports written about residents 12(5) must ensure that residents dignity is respected. 30.11.05 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 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 19 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 218 Kingsway D56_D05_26582_Kingsway_241869_300805_Stage2.doc Version 1.40 Page 20 - 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. 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