Inspection on 04/01/07 for 23 Duston Road

This inspection was carried out on 4th January 2007.

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

23 Duston Road 22/05/08

23 Duston Road 30/01/06

23 Duston Road 31/01/05

23 Duston Road 06/05/04

Similar services:

Trevayler Residential Care Home

St Marys Nursing Home

Thornham Grove

Thistle Hill Hall

Chater Lodge

Conifer Lodge

Tixover Care Home

Toynton College (Cluster Five)

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

CARE HOME ADULTS 18-65 23 Duston Road Duston Northampton Northants NN5 5AR Lead Inspector Judith Roan Key Unannounced Inspection 4th January 2007 10:00 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 23 Duston Road Address Duston Northampton Northants NN5 5AR 01604 754559 01604 588276 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) The Richardson Partnership for Care Mr Brian Richardson, Mrs Jacqueline Richardson, Miss Laura Richardson, Mr Gregory Paul Cheater Ms Michele Shalini D`Souza Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10), Physical disability (1) of places 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. No person falling within the category MD can be admitted where there are already 7 persons of category MD already in the Home. The Home can accommodate 1 Service User within the category MD who also has needs within the category PD. No person under 22 years and over 52 years may be admitted to the Home. The Service Users admitted to the home who fall within the category MD must have an Acquired Brain Injury 30th January 2006 Date of last inspection Brief Description of the Service: 23 Duston Road is a care home providing personal care and accommodation for 10 service users with Mental Disorder (Acquired Brain Injury) one of whom may have an additional Physical Disability. The Home is located in a suburb of Northampton close to the local shopping centre of St. James and near to local pub and other amenities. The Home can be easily accessed by public transport and is approximately a mile and a half from Northampton Town Centre. The Home consists of a three-storey building offering single bedroom accommodation to all Service Users. All bedrooms have en suite facilities. The ground floor bedroom has an adjacent, specially adapted bathroom to cater for one Service User who may have additional physical disability. The Home does not have a lift and Service Users accommodated on the upper floors must be able to negotiate stairs. There are two lounges and a separate dining room. The Home has disabled access, parking to the front and Service Users are provided with a rear garden. Fee levels start at £1781 per week but are dependent on the complexity of the service users needs and the level of support required to meet the needs. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection (CSCI) is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 3 service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The inspection took place during the morning and afternoon, over a period of 6.5 hours and was carried out on an unannounced basis. The registered manager prior to the inspection completed a pre-inspection questionnaire. The inspector was accompanied by their manager as part of performance management within the CSCI. What the service does well: What has improved since the last inspection? What they could do better: This inspection did not generate any requirements or recommendations. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A detailed assessment process ensures that service users can be met within the home. EVIDENCE: Service users who move into the home do have a comprehensive assessment of their support needs. There has been no new service user admitted into the home since the last inspection. Files reviewed demonstrated that there was ongoing assessment throughout the admission period at which time frequent reviews are undertaken to ensure that the support service is meeting individual needs. Good information is available for service users and their families /representatives with all having a written contract that clearly sets out the terms and conditions within the care home. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Care plans with supporting risk assessments have clear and detailed goals, which demonstrate that service users have been fully involved with their development. EVIDENCE: The inspector reviewed care plans and records of three service user. Care plans are very detailed and provide information about individuals needs, wishes and preferences. The information also clearly informs support worker how the care is to be implemented. Care plans do promote service users independence and a good quality of life. Risk assessments were detailed and include intervention strategies on how behaviours are to be managed consistently with the promotion of independence, welfare and safety. Support workers all receive training in the management of behaviour and demonstrated a good understanding of how to support the service users case tracked. The Inspector spoke with two service users and observed others that were not able to communicate. Support workers demonstrated how they communicated effectively with service users that had minimal communication skills. Service users confirmed that they were involved in the review of their care plans along 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 10 with their family or representatives. These occurred on a regular basis or as needs changed. Service users receive support from family, friends and professional representatives at reviews. Records have clear processes for decision-making and advocates are used appropriately. Service users are further assisted in making decision within the home during house meetings at which minutes are taken. Issues raised during these meetings are acted upon. The cultural needs of service users are fully met by a staff team that reflects the multi-cultural population of service users. Individual needs are well met within the home. An issue concerning one service user that can become racist is managed positively within the home. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users choices of lifestyles are promoted with opportunities provided within the home and the community. EVIDENCE: Clear care plans support service users with their activities. In discussion with one service users they expressed a wish to have Internet access for their computer in their own room. In discussion with the Registered manager they confirmed that there is access for service users within the home, but they would take this issue up with the individual and explore how this could be achieved. The Registered Manager also confirmed that a requested activity for this service was on hold due to safety issues relating to their wheelchair. A new chair had been ordered. Service users had good opportunities to access community activities of their choice. In discussion with service users, support worker and registered manager it was established that there is a range of educational, therapeutic and leisure available. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 12 Contact with families and friends depend on the service user, some are visited at the home whilst other are supported to visit them in their own homes. Annual holidays are arranged according to the choice of individual service users and are fully supported by the staff team. Meals at the home are freshly cooked from a balanced and health menu. One service users spoken with confirmed that as they were a poor eater fortified drinks that were evident in the medication cabinet supplemented their diet. Records confirm that these are regularly taken. Service users all confirmed that the meals were of a good quality and offered them a choice. Menus were developed in discussion with service users at meetings. The meal served on the day of the inspection was presented well and ample in quantity. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19.20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Personal and Health care needs of service users are positively met. EVIDENCE: Service users spoke of good support with their personal care and were supported according to their preferences. Daily routines were flexible to meet agreed support. Health care needs are monitored and service users are supported to access local primary health facilities. Health care needs are fully recorded and monitored. Concerns for one service user with regard to their mobility was actively being supported by the Registered manager to gain the daily living aids that they needed. Care plans were detailed and had appropriate manual handling risk assessments in place to support service users and minimise risks. Medication systems are managed effectively in the home with two members of staff completing the complex task. The controls in place protected service users from mistakes. In reviewing the systems the inspector evidenced that all records case tracked were correct. The management of the system is delegated to one member of staff who is trained and responsible for stock control. Effective back up is in place if they are away. All support workers who assist with the administration of medication are fully trained. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Robust complaints and safeguarding procedures within the home protect service users. EVIDENCE: Since the last inspection the CSCI has received two complaints. One has been fully investigated and satisfactory evidence has been submitted to the lead inspector with the complaint not being upheld. The second is a safeguarding issue and is still being investigated. The Registered Manager has implemented the safeguarding procedures used within the organisation and action taken to suspend staff during the investigation Service users are protected by the policies of the service, with all staff being fully aware the whistle-blowing procedures. Good monitoring of concerns by the Registered manager ensures that any concerns are taken seriously and acted upon. All staff receive abuse awareness training as part of their induction training at the home. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a safe, clean and homely environment. EVIDENCE: Service users commented that they were happy with their rooms, which were seen to be personalised and comfortable. One service is having modification to ensure that the support they need with their personal care is provided in a safe and respectful way. In discussion with the manager about emergency call systems it was confirmed that mobile systems are used as appropriate. The home is well decorated and there is an ongoing maintenance programme in place. The external facia to the home is in need of rendering and the manager confirmed that this was planned for this year. An unpleasant odour was present on entering the home, but after the normal daily cleaning routine this was dealt with. In discussion with the Registered Manager the issue had been acted upon and new flooring is planned to ensure that accidents with body fluids are managed immediately. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 16 The home has a range of bathing facilities that meet the choices of service users resident at the home. Another resident with higher physical needs has their needs fully met with appropriate adaptations and ground floor access. Support workers were seen to use effective hygiene routines and wear personal protective equipment for personal support tasks. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. A staff team supports Service users that are well trained, supervised and competent. EVIDENCE: Support workers have clear roles whilst on shift and were familiar with their responsibilities in support for service users and member of the staff team. Support worker spoken with were all key workers to the service users case tracked. In discussion with staff it was evident that they were not only very knowledgeable about the needs of individuals whom they were key worker for but were also aware of other that they supported throughout their shift. Fifty percent of the staff team hold National Vocational Qualifications in care at level two or above. All new employees undertake a comprehensive induction programme that meets the required training fin skills for care. In addition to induction the organisation supports staff on training to develop their skills in meeting the needs of the people with a Brain Injury and focusing on communications. All members of the staff team receive training to use appropriate intervention skills when it is necessary. Staff spoke about the support they receive within the organisation, which includes regular recorded supervisions, team meetings, and support for training. They all agreed that the manager was both approachable and supportive. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39.42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users know that their views will be listened to and acted upon. Systems within the home ensure that service users rights and best interests are protected. EVIDENCE: The Registered Manager demonstrated a good knowledge of the systems in place within the home and their responsibilities in relation to regulation and National minimum Standards. Service user told the inspector that they met frequently with the manager and staff team to share their views. One service user had requested a smoking area and this was accommodated by the provision of an outside room where they and another resident spent happy times knowing that others who did not like smoke were protected. Service user are supported by independent appointees to manage their own independent bank accounts 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 19 The manager ensures that all health & safety records are completed with staff receiving training within induction programmes and regular updates. Quality assurance monitoring is completed with residents and their representative. Bi-annual reports are available with action plans on future developments. 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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 4 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 4 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 4 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 4 X 3 X 3 X X 3 X 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? N/A 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. Standard Regulation Requirement Timescale for action 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 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 23 Duston Road DS0000043835.V322601.R01.S.doc Version 5.2 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!