Inspection on 23/02/07 for Warwick Road, 2

This inspection was carried out on 23rd February 2007.

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 found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Warwick Road, 2 11/11/08

Warwick Road, 2 01/11/05

Warwick Road, 2 12/07/05

Warwick Road, 2 19/01/05

Warwick Road, 2 05/10/04

Warwick Road, 2 18/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Warwick Road, 2 2 Warwick Road Wallsend Tyne And Wear NE28 6RT Lead Inspector Deborah Haugh Key Unannounced Inspection 23rd & 26th February 2007 10:00 Warwick Road, 2 DS0000000353.V322900.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 Warwick Road, 2 DS0000000353.V322900.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. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Warwick Road, 2 Address 2 Warwick Road Wallsend Tyne And Wear NE28 6RT 0191 234 3933 F/P 0191 234 3933 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) Northern Life Care Limited T/A U.B.U. Emma S Adamson Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom residential accommodation with board and care is provided at any one time shall not exceed 4 men or women 3rd November 2005 Date of last inspection Brief Description of the Service: The home is privately owned by Northern Life Care and is registered to provide care for four adults with learning disabilities who may also have physical disabilities. The home does not provide nursing care. It was purpose built in recent years and provides homely ground floor accommodation and each service user has a single bedroom. It is situated in the centre of Wallsend and close to all local amenities. It is immediately adjacent to No 4 Warwick Road, which provides a similar service. The current scale of fees is £62.35 per week. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The un-announced inspection took place on 23/02/07 from 10.00 until 2.30pm and 26/02/07 from 10.00am until 10.35am. The Registered Manager, Emma Adamson is currently on maternity leave so the Acting Manager Sue Inglis was on duty during both visits. Time was spent looking around the home to check the cleanliness, maintenance and decoration during the visit. Prior to the inspection questionnaires were provided to service users and relatives. Two service users completed a questionnaire with assistance both shared positives about the care, which they receive, and being consulted about their preferences. Time was also spent observing the contact between the service users and staff. No questionnaires were completed by Relatives/Visitors. At the time of the inspection there were no visitors. Two plans of care were examined. Health and safety, staff recruitment, training, protection from abuse arrangements, administration and management of medication were checked. What the service does well: No 2 Warwick Rd has a homely atmosphere. The communal living areas help provide a personalised approach and service users bedrooms are individualised. The bedrooms and bathrooms have been redecorated and new flooring provided in bedrooms and the lounge. The atmosphere in the home was relaxed and positive. Staff demonstrated their knowledge of the service users needs and were very responsive to the wishes expressed by the people. Plans of care are detailed and cover a range of developmental and support needs. There is a good multi-disciplinary approach to care. The Acting Manager, Sue Inglis is covering for the Registered Manager’s maternity leave and people felt the management of the home continued to be supportive. Staff are clear about safeguarding service users from potential abuse. Since the last inspection only two staff have left the home. The staff team have good relationships with the service users. Staff have received a range of training and 58 have NVQ Level 2 or above (the minimum standard is 50 ) Staffing levels were appropriate to meet the needs of the service users. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Warwick Road, 2 DS0000000353.V322900.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 Warwick Road, 2 DS0000000353.V322900.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): Quality in this outcome area is good. NMS 2 was assessed at this inspection. The home identifies the needs and aspirations of service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have been no new admissions to the home since the 4 people came to live at the home. A multi-disciplinary team looked at the service users needs and wishes, which were assessed prior to coming to the home. Service users were supported to choose their own bedroom and décor as well the communal areas. Warwick Road, 2 DS0000000353.V322900.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): Quality in this outcome area is good. NMS 6,7 & 9 were assessed at this inspection. Care plans are detailed and identify the needs of the service users and actions to meet them but one area must improve. Risk assessments provide guidance to staff and protect service users. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Two care plans were examined, staff discussed their approaches to caring for the service users and interactions between service users and staff were observed. Staff demonstrated and shared their knowledge of the people they support and care for and this is reflected in the care plans. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 10 Care plans are very comprehensive and look at a full range of needs of the service users. They include information on the support package from the organisation and other agencies. However care plans must be in place regarding service users who need to take medication ’when required’ which gives clear guidance and records of the circumstances and review of such times when the medication is used. Communication with the service users is complex and the various methods developed by the staff are clearly identified. Targeted ambitions are identified each year so that new activities and experiences are introduced. The care plans are evaluated on a regular basis and reviews are carried out on a six monthly basis. Limitations of choice to safeguard the service users are fully recorded. Risk assessments covering all aspects of the service users’ lives are recorded. Risk assessments are in place for dealing with service users behaviours that challenge the home. Steps to address behaviours are recorded. Warwick Road, 2 DS0000000353.V322900.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): Quality in this outcome area is good. NMS 12,13,15,16 & 17 were assessed at this inspection. Service users have access to a variety of activities both inside and outside of the home. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users dietary needs and tastes. Service users maintain relationships with family and friends. Service users rights are respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Visitors are welcome in the home at any time and evidence in care plans shows that relationships are supported. Some service users have advocates who support them to make decisions. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 12 Routines in the home are centred around the preferences and needs of the service users. Evidence is found in the care plans, speaking to staff and observations during the inspection. Service users go shopping, attend a gardening group, and enjoy discos, meals out, drama and hydrotherapy with support from staff and advocates. Targeted ambitions are identified for service users, which plan new opportunities and personal development such as new activities and experiences. The home has a 3-week menu plan and another special dietary 3-week menu for one person. A dietician has provided advice and checked the menus for their nutritional content. Advice is sought from eating and swallowing professionals. The dietary needs of the service users are being met and monitored. Care plans detail any dietary needs and interventions. Warwick Road, 2 DS0000000353.V322900.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): Quality in this outcome area is good. NMS 18,19 & 20 were assessed at this inspection. Care plans record the approach to be taken to care so service users receive personal care in a way that respects their dignity and privacy. The health needs of service users well met with multi disciplinary working taking place on a regular basis. The medication at this home is being managed so service users receive the care they require. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff monitor service users health needs, which are recorded in the care plans. Care plans record the preferences and routines and staff demonstrated these. Routine health checks are carried out and service users attend appointments with relevant health care professionals with staff. The changing needs of service users are monitored and professional advice is sought and care plans reflect this. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 14 Medication arrangements are satisfactory and the home uses a monitored dosage system. Audits are completed bi-monthly by the acting manager using an audit tool from CSCI. At the end of each month medication orders are checked. Staff are trained. One area mentioned in NMS 6 refers to the need to provide a care plan for service users who need to take medication ’when required’ which gives clear guidance and records of the circumstances and review of such times when the medication is used. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. NMS 22 & 23 were assessed at this inspection. Complaints are dealt with appropriately. Service users are protected from abuse and harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There has been one recent complaint since the last inspection and an investigating officer of UBU, the Registered Provider, is investigating this. Staff are clear about UBU Whistle Blowing Policy where they would report poor practice to management. Staff are aware of the different types of abuse. Care plans are detailed and guide the practice of staff when dealing with any service users behaviours, which challenge the home. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 16 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): Quality in this outcome area is good. NMS 24 & 30 were assessed at this inspection Service users live in a well maintained, clean and decorated home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection all of the bedrooms and the bathrooms have been redecorated and new flooring provided in the bedrooms, lounge and corridor. The lounge carpet is due to be cleaned due to use. The kitchen was clean. The laundry and arrangements for infection control are appropriate. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 17 Bedrooms are personalised and decisions about decoration and furnishing is discussed with service users. The shower/wc flooring is no longer impermeable, the radiator cover and shower pole is rusty. The Acting Manager assured the Inspector that these matters were being dealt with by UBU. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. NMS 32,34 & 35 were assessed at this inspection. Staffing numbers are appropriate to the assessed needs of the residents, size, layout and purpose of the home, at all times. Service users are cared for by staff who are trained to NVQ Level 2 or above. Robust staff recruitment and training ensures that service users are cared for by appropriate and competent staff however staffing records must improve. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home maintains the level of staffing in accordance with previous agreements with the local authority and this reflects the size and layout of the building and the needs of the residents currently living in the home. The current levels of staffing are a minimum of 2 care staff on duty during the day with extra staffing where the needs of service users have changed (20 hours per week one-to-one) or activities require more support. There is 1 waking night staff with 1 person sleeping in. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 19 Recruitment systems are robust. Five staff records were checked. All checks are in place, which include at least two referees, Protection of Vulnerable Adults (POVA) and Criminal Records Bureau clearances. However staffing records, which are required, are not consistently recorded such as staff photographs, their address, when they started work, their job title and hours that they are contracted to work and any other records in relation to their employment. Over 50 of staff are qualified to NVQ Level 2 and to Level 3. Staff receive training in areas such as medication, POVA, dementia, health and safety, food hygiene moving and handling, epilepsy, eating and swallowing. However staff must receive fire instruction at the appropriate timescale (3 monthly for night staff and 6 monthly for day staff) and records maintained (See NMS 42). Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 20 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): Quality in this outcome area is good. NMS 37,39 & 42 were assessed at this inspection. Service users live in a home with robust management arrangements. Systems are in place to protect service users from health and safety hazards. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager who is currently on maternity leave completed her Registered Managers Award and NVQ 4 in Care in April 2006. The Acting Manager Sue Inglis is experienced, competent and qualified. She has the Registered Managers Award and NVQ 4 in Care. Sue is managing the home effectively and people feel they can go to her if they have concerns. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 21 UBU and the management of the home have quality assurance systems in place. Monthly audits are completed and reports forwarded to CSCI under Regulation 26 visits by the Registered Provider. Maintenance checks and records are in place and risks are managed. During the inspection there was a problem with an adjustable bed and this was dealt with appropriately with no affect on the service user involved. Checks include the fire log and maintenance of equipment. Gas and electrical testing, hot water and Legionella prevention is in place. Moving and handling equipment is serviced at the required time. Electrical servicing is in place. A Fire Risk Assessment is in place. However staff must receive fire instruction at the appropriate timescale (3 monthly for night staff and 6 monthly for day staff) and records maintained. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 22 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 X 2 3 3 X 4 X 5 X 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 3 33 3 34 2 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 2 X Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 23 N/A 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 YA6 Regulation 15 Requirement The Registered Person must ensure that a care plan must be in place regarding service users who need to take medication ’when required’ which gives clear guidance and records of the circumstances and review of such times when the medication is used. The Registered Person must ensure that staff records are consistently in place, which include staff photographs, their address, when they started work, their job title, and hours which they are contracted to work and any other records in relation to their employment. Timescale for action 31/03/07 2. YA34 17 schedule 4 31/03/07 3. YA42 23(4) The Registered Person must 30/04/07 ensure that staff receive fire instruction at the appropriate timescale (3 monthly for night staff and 6 monthly for day staff) and records maintained. Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 24 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 Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR 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 Warwick Road, 2 DS0000000353.V322900.R01.S.doc Version 5.2 Page 26 - 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!