CARE HOME ADULTS 18-65
27 Islip Road Oxford OX2 7SN Lead Inspector
Merry Wahogo Unannounced 27.04.05 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. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service 27 Islip Road Address 27, Islip Road, Oxford, OX2 7SN 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) 01865 554920 01865 559243 sue.fawcett@advanceuk.org Advance Housing and Support Ltd Susan Fawcett Care Home 9 Category(ies) of Learning Disability (LD) registration, with number of places 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: Islip Road is a large house in a residential street in the north of Oxford city with front and back gardens. It has good access to local facilities. It provides accommodation for up to nine adults with learning difficulties and is run by Advance Housing and Support Ltd, which is a national organisation. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out to assess what improvements the home had been able to make since the last annual inspection, especially in relation to repairs and redecoration. The inspector spoke to several residents, toured the premises, sat in on a staff meeting and looked at some records as well as speaking to the manager. What the service does well: What has improved since the last inspection?
The most marked improvement has been the development in residents confidence and self-help skills. The manager has created a staff training record that has enabled her to see at a glance general training gaps as well as individual training needs. The home has some new furniture in communal areas and bedrooms. Some other repairs have also been done. All staff have now had at least basic training in protecting vulnerable adults. The written information about the home has been revised. The files giving quick access to essential information about residents now contain their photos. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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 standard(s) The inspector has not made a judgement on these standards as they will be looked at at the next inspection EVIDENCE: None of these standards were inspected on this occasion. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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 standard(s) 7, 8 The home is good at identifying and meeting individual needs and choices. Staff are to be commended for pursuing solutions to residents’ needs and choices, even where there are obstacles to be overcome. EVIDENCE: Some residents were still in bed at 10 a.m. whilst others were already up and about and had had their breakfast. One resident had access to a care worker who spoke his first language and this resident had clearly become more settled in the home. His behaviour had become more relaxed than when he first moved in. Another resident explained that she chooses to help staff in the kitchen sometimes, though not always. Yet another resident told the inspector that she had decided she wanted to live in the home, having originally arrived on a temporary basis whilst accommodation was being sorted out. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) 12, 13, 14, 15 The manager and her staff are making full use of Internet access to increase the range of leisure opportunities available to residents, and are to be commended for this. They are also doing well at ensuring that each resident enjoys leisure facilities that suit their particular needs. Finally all staff are to be commended for struggling to get the correct balance between the rights of individual residents and the group, as well as that between residents and their families. EVIDENCE: One resident enthusiastically told the inspector about her enjoyment of a keep fit class and explained to the inspector why she needed that. The inspector also heard from residents how much they liked going to local evening activities club, and explained that they sometimes had a meal before going to this and sometimes had snacks at the club instead. One resident had been helped to speak more English. Staff have advocated strongly for the rights of some residents who had expressed a wish for sexual relationships. This has been worked out steadily over time in partnership with families and advocates, so that any major obstacles had been overcome. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 11 The manager reports being able to use the Internet on the system which has recently been introduced by Advance Housing and Support Ltd, to locate new leisure activities and also holiday opportunities. Two residents spoke to the inspector about their holidays this year at Hill End in Oxfordshire and in Cornwall; both were very much looking forward to these opportunities. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) 18, 20 The home is good at encouraging independence in relation to personal health care. EVIDENCE: One resident was found to be about to shower herself, when the inspector arrived. When she later came down to the sitting-room area, she was asked if she would like help in drying her hair and agreed that she would. This help was then given in a very relaxed fashion. The inspector was also told that one resident had become able to administer her own medication since the last inspection. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) 23 The home is committed to ensuring best practice in relation to safeguarding the residents. EVIDENCE: The inspector arrived on a day when there was to be a team meeting. The first item on the agenda was the policy on protection of vulnerable adults. Staff talked about a video they had viewed only the day before which they said provided useful coverage of institutional abuse, which may not otherwise have been recognised as such by staff. All interactions observed by the inspector, were respectful and thoughtful. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) 24,26, 27 Islip Road has comfortable and adequate furnishings and retains a homely atmosphere. Several bedrooms need redecoration and new carpets. More investment is needed to improve toilets and bathrooms. EVIDENCE: Several of the bedrooms seen by the inspector, had very worn and stained carpets. There was also a need for general redecoration in these bedrooms. Having said this, the bedrooms very much reflected the characters of the particular residents using them, because of the use of posters, photographs and ornaments, and had a homely feel to them. One bathroom had had a new toilet seat installed, but still needs refurbishment and redecoration as it is rather bare. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) The inspector has not made a judgement on these standards as they will be looked at at the next inspection EVIDENCE: None of these standards were looked at on this occasion. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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) 42 The manager acts promptly to improve on health and safety issues, but is not always sufficiently backed up by Advance Housing and Support Ltd in this respect. EVIDENCE: A broken sash window mechanism in one bedroom had been repaired since the last inspection. Also, after consulting the fire officer, a fire door which posed a hazard to two residents in particular, has been removed and grab rails have been inserted to assist these residents in moving safely on to the staircase. The manager had put in place improvements that lay within her power, in terms of her budget. Requests for repairs as required either by this commission or by environmental health officers, did not, however, appear to be being met quickly by Advance Housing and Support Ltd. Thus holes in the kitchen work surfaces had not been repaired despite requirements noted in the Environmental Health inspection report dated 3 March 2005. 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 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 x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score x 3 3 x x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x 2 2 x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 4 x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
27 Islip Road Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 18 Yes 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 YA26 Regulation 12(4) Requirement The registered manager must make arrangements for fuseboxes to be removed from residents bedrooms Advance Housing must carry out any repairs or refurbishment required by the Environmental Health Officer or the Commission to ensure that the home is fit for purpose. Timescale for action 30 June 2005 Ongoing 2. YA42 13(4a) 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 27 Islip Road H57_H08_S13094_Islip Road_V223890_ 270405_ stage 4.doc Version 1.30 Page 19 Commission for Social Care Inspection Burgner House 4630 Kingsgate Oxford Business Park (South) Cowley, Oxford, OX4 2SU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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