Inspection on 30/08/05 for 27 Islip Road

This inspection was carried out on 30th 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

27 Islip Road 11/12/06

27 Islip Road 27/04/05

27 Islip Road 07/12/04

27 Islip Road 01/07/04

27 Islip Road 12/02/04

27 Islip Road 02/09/03

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 27 Islip Road 27 Islip Road Oxford OX2 7SN Lead Inspector Julian Griffiths Unannounced 30 August 2005 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 27 Islip Road V246405 300805 Stage4.doc Version 1.40 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 Limited Susan Fawcett Care Home 9 Category(ies) of LD registration, with number of places 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 27 April 2005 Brief Description of the Service: 27 Islip Road is a large detached house in a residential street in north Oxford, with good access to local amenities. It is run by Advance Housing and Support Ltd. and provides support and accommodation for up to 9 people with learning disabilities. Staffing support is provided 24 hours a day. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced which means that the home had no prior notice of the inspector’s visit. The inspector was in the home from 12.15pm until 5.15pm and during that time had conversations with residents, a visiting relative, staff members and the manager, observed staff at work, looked at some written records and documents and visited some, but not all, parts of the house. Everyone in the home was welcoming and helpful throughout the inspection. This was a positive inspection that indicated a good standard of support and accommodation. Residents clearly enjoyed good relationships with each other and with staff. One resident said that the best thing about the home was the staff and all but one who were asked spoke very highly of the overall service. One resident was critical about particular aspects of the service but after following these up the inspector was satisfied that these criticisms did not reflect the objective reality. No requirements or recommendations were made. What the service does well: Advance carefully assesses the wishes and needs of people before agreeing that they can move in to the home. Prospective residents have the opportunity to spend time at the home before moving in. Each resident has his or her own written plan of support which sets out individual wishes and needs and is regularly reviewed. Residents have good opportunities to express their views on the home and these are listened to. Residents are supported to take risks as part of an independent lifestyle. Residents have frequent and wide-ranging opportunities for learning, employment and leisure activities and are often out of the house. Relationships with friends and relatives are encouraged and enabled. Residents’ rights and responsibilities are respected in their daily lives. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 6 Residents have access to a choice of good food which they enjoy. The home tries hard to meet residents’ needs which arise from their culture or ethnicity. Residents have good access to community healthcare. Residents are enabled to manage their own medication where this can be done safely. Residents know how to make a complaint, and the home acts on complaints made. The home was comfortable, homely, clean and well maintained in all rooms visited by the inspector. Residents are happy with their bedrooms. Shared spaces are comfortable. Residents are happy with the support they receive from staff. The home is striving to ensure that all staff are properly trained and qualified. The manager is working towards a nationally recognised qualification in care home management. 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. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 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 27 Islip Road V246405 300805 Stage4.doc Version 1.40 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) 2 and 4. Advance carefully assesses the wishes and needs of people before agreeing that they can move in to the home. Prospective residents have the opportunity to spend time at the home before moving in. EVIDENCE: The inspector saw the pre-admission documentation in respect of one of the most recent admissions to the home, which took place about a year prior to the inspection. This consisted of a completed Advance application form completed and signed by the prospective resident and his care manager, and a separate care management assessment. Taken together these gave a detailed and comprehensive picture of the person’s needs and wishes and reasons for wanting to be considered for admission. There was also a record of a meeting which had taken place between the home’s manager, the prospective resident, his care manager and a close relative to discuss the person’s needs. A staff member told the inspector that a prospective resident would visit the home to meet staff and residents, would stay for tea, would have the opportunity to spend increasing amounts of time at the home and to stay overnight. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 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) 6, 8 and 9. Each resident has his or her own written plan of support which sets out individual wishes and needs and is regularly reviewed. Residents have good opportunities to express their views on the home and these are listened to. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: The home uses a system of person-centred planning to identify what each resident wants and needs in terms of practical support and accommodation, nutrition, personal and health care, leisure, relationships, employment and learning. The inspector saw two such plans and it was clear that the resident him or herself was fully involved in their production. The inspector spoke with a close relative of one resident who said that she had the opportunity to be involved in producing the resident’s plan. The plans included a practical action plan, reviewed monthly by the resident and his or her keyworker, identifying the main things to be done to make the choices made by the resident happen, 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 10 and recording the actions taken and goals achieved. In one plan seen it was not apparent from the record that all agreed actions had been achieved by the target date. A resident told the inspector that there were residents’ meetings at which there were discussions about activities and things to do. She said that when people talked about problems at the meetings, they were sorted out. The inspector saw records of monthly residents’ meetings, where the meeting and the planned agenda were well publicised to residents in advance. Agendas seen included such issues as activities planning, voting, fire precautions, caring for and respecting each other, and included space for residents to bring up any other issues that they wanted to discuss. A resident’s person-centred plan was seen to include recorded risk assessments which identified activities the person wanted to pursue, the risks involved and the action needed by staff to enable him to do the activities safely. The assessments showed evidence of recent and regular review. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Residents have frequent and wide-ranging opportunities for learning, employment and leisure activities and are often out of the house. Relationships with friends and relatives are encouraged and enabled. Residents’ rights and responsibilities are respected in their daily lives. Residents have access to a choice of good food which they enjoy. The home tries hard to meet residents’ needs which arise from their culture or ethnicity. EVIDENCE: The inspector had conversations with several residents who talked about their daily lives and routines. One told the inspector about her part-time cleaning job and her college course as part of which she was, for the first time, taking exams. She spoke of her summer holiday at a seaside resort hotel which she had enjoyed. Another resident spoke of her part-time job in a shop and of her 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 12 recent horse riding holiday. One resident spoke of his college course which involved cooking which he enjoyed. On the day of the inspection some residents had been out shopping, others had been to the hairdresser and one was out at work. A resident’s relative told the inspector about some of the activities the resident had been enabled to do and which she had greatly valued. Discussions with residents and staff and a conversation with a resident’s relative indicated that residents were enabled to keep in contact with friends and relatives. This included staff providing transport for a resident to visit his parents and residents regularly visiting and staying with parents and communicating by telephone. Two residents had been enabled to share a bedroom in accordance with their wishes. Residents told the inspector that staff members respected their privacy and did not enter their bedrooms uninvited. Residents’ bedrooms were seen to be fitted with appropriate locks, with residents keeping the key to their own rooms. Residents were seen to be able to use all parts of the home freely and to be able to spend time with others in communal rooms or on their own in their bedrooms as they wished. Residents confirmed that their mail was distributed to them unopened. Records were seen relating to a situation in which one resident’s activities were impinging on the rights of others, who had complained about this. The records showed that this had been dealt with sensitively and to the satisfaction of all parties. From observation during the inspection relationships between staff and residents appeared to be good. There was a warm familiarity, residents were clearly at ease with staff and staff, whilst warm, were at all times respectful. There were clearly strong relationships between residents themselves, including particular friendships. Residents were seen to help and support each other, there was conversation, humour and physical affection. One resident’s more negative comments about relationships with staff and other residents were not borne out in the inspector’s observations, nor in discussion with staff and a visitor, nor in written records seen. Residents told the inspector that they were involved in some housekeeping tasks, for example cleaning and meal preparation, but that this was largely a matter of choice. When the inspector arrived a resident and staff member were using fresh vegetables, which they had bought that morning, to prepare a shepherd’s pie for lunch, a dish described by the resident as her favourite. All residents who were asked said that the food provided was good and plentiful and that drinks 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 13 and snacks were freely available between meals. A staff member said that menus were not planned in advance but that decisions about what to eat were made on the day, and that there was always a selection of frozen pre-prepared meals available to choose from should any resident not want what was being cooked on the day. Supported by staff a resident prepared his own packed lunches for college days. A staff member said that some residents chose to shop for their own food. One resident had needs relating to his culture, language and ethnicity. Conversations with staff and the manager showed that efforts had been, and were being, made to meet these needs through the provision of staff members who could speak the same language, enabling access to culturally and linguistically appropriate worship and music, and the availability of familiar foods. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 14 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) 19 and 20 Residents have good access to community healthcare. Residents are enabled to manage their own medication where this can be done safely. EVIDENCE: All residents who were asked said that there was no problem in seeing the doctor whenever they needed to, and that the doctor was good. One said that, whilst she could see the doctor in private she preferred to have a staff member with her. Most residents who were asked said that they had good access to dental care; one had been to the dentist on the day of the inspection. One resident said that she did not see the dentist, but subsequent discussion with staff indicated that the resident had been offered treatment but had declined it and was on the waiting list for another opportunity. Records of healthcare were seen and indicated that residents were seeing the GP, dentist and other specialists as needed. One resident was seen to keep her own medication in her room. It was not in a lockable cabinet, however the room itself was lockable and kept locked if the resident was not in it. Another resident had managed his own medication 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 15 before moving to the home. However the manager said that in the context of life at the home it was more likely that the resident could forget to take the medication, therefore it was kept in the office with the resident himself being supported by staff to manage some elements of its management. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 16 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 know how to make a complaint, and the home acts on complaints made. EVIDENCE: The home has a complaints procedure which meets the required standard. A copy of this was seen in the home’s office. The manager said that it was also on display elsewhere in the home and that the family of every resident had been sent a copy. One resident said that she had made a complaint to the manager and that it had been dealt with to her satisfaction. A record of this complaint was seen by the inspector. Another resident described in some detail the process for making a complaint, but said that she had never felt the need to do so. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 17 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, 28 and 30 The home was comfortable, homely, clean and well maintained in all rooms visited by the inspector. Residents are happy with their bedrooms. Shared spaces are comfortable. EVIDENCE: The home is domestic rather than institutional in character and the inspector found the atmosphere to be very homely. The home is in an ordinary residential street with nothing to make it stand out as a care home. All the amenities of Summertown are within easy walking distance and access to Oxford city centre via public transport is good. Decoration in all rooms visited was of a good, or at least satisfactory, standard. A visiting relative commented on recent re-decoration which, she said, had been a positive improvement. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 18 Some residents invited the inspector into their private bedrooms. The inspector was struck by the different characters of the rooms he saw, which gave clear evidence of the interests and tastes of their occupants. The home’s shared spaces are the lounge, dining room, visitors’ room, kitchen and garden. The lounge was homely and furnished in a way that promoted relaxation. Residents were clearly comfortable there. The garden was well maintained and private and furnished with a table and chairs. Some staff and residents chose to eat their lunch in the garden on the day of the inspection. All areas seen by the inspector were clean and odour free. A resident told the inspector that it was always kept clean. The manager said that both she and the Deputy Manager had attended an infection control training course, and she described daily disinfection routines in the home. She said that there was no clinical waste to dispose of other than dressings on very rare occasions. The home’s laundry facilities were not inspected on this occasion, but residents told the inspector that they did their own laundry, with staff support if needed, and they found it satisfactory. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 19 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) 33 and 35 Residents are happy with the support they receive from staff. The home is striving to ensure that all staff are properly trained and qualified. EVIDENCE: All residents who were asked said that there was always a staff member available if they needed one. Discussion with the manager and staff indicated that there was a minimum of one staff member on duty during the day, but more often than not there were two or more, thus facilitating activities outside the home. A staff member said that there were always enough staff on duty to support residents’ activities. At the time of the inspection the inspector saw three staff members on duty, not including the manager and deputy manager who were both in the home. The manager said that at night there was one staff member sleeping-in oncall, with a senior staff member on-call via telephone and able to be in the home within 30 minutes. She said that, whilst there was no routine need for more staff in the home at night, the occasional crisis (the last one had been 18 months ago) had made her question whether another staff member would be beneficial. However she had concluded that the present arrangement was safe and satisfactory. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 20 One resident said “Staff’s alright”, another said “Staff are lovely; they look after me; they mix along OK; they make sure I eat properly”. A resident described the role of her keyworker with whom she said she got on especially well: ”My keyworker takes me out, helps me with my room. If I’ve got a problem I tell her or the boss – they’re good at sorting out problems”. One resident said that her keyworker was often too busy to talk with her, however subsequent discussion with the keyworker and the manager, and observation by the inspector, led him to conclude that this criticism did not reflect objective reality. Discussion with staff members and the manager and inspection of records indicated that there was an active programme of staff training and development which included a structured induction and foundation training programme for new staff. These included such elements as Diversity & Equality, Personal Safety, Introductions to Learning Disability and Mental Health, 1st Aid, Manual Handling, Challenging Behaviour and Adult Protection amongst many others. The manager said that the home had experienced problems in accessing National Vocational Qualification assessors with the result that the NVQ training programme had stalled temporarily. She said that out of 7 staff two were still doing their induction training, three were registered for, or part way through NVQ Levels 3 or 4 but could not progress for lack of an assessor, one was a registered learning disability nurse, and one had been excused NVQ training because of her extensive experience and nearness to retirement. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 21 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) 37 The manager is working towards a nationally recognised qualification in care home management. EVIDENCE: The manager said that the was currently working towards NVQ level 4 in care, and the Registered Manager’s Award, which she anticipated she would have completed by September 2007. 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 x Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 27 Islip Road Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 23 No 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 Regulation None 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. 1. Refer to Standard None Good Practice Recommendations 27 Islip Road H57-H08 S13094 27 Islip Road V246405 300805 Stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection Burgner House, Cascade Way 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 © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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