Inspection on 28/11/05 for Warwick Road, 4

This inspection was carried out on 28th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 13 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Warwick Road, 4 20/10/09

Warwick Road, 4 19/09/07

Warwick Road, 4 31/07/06

Warwick Road, 4 20/07/05

Warwick Road, 4 16/02/05

Warwick Road, 4 04/08/04

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, 4 4 Warwick Road Wallsend Tyne And Wear NE28 6RT Lead Inspector Deborah Haugh Unannounced Inspection 28th November 2005 10:00 DS0000000358.V258042.R01.S.doc Version 5.0 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 DS0000000358.V258042.R01.S.doc Version 5.0 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. DS0000000358.V258042.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Warwick Road, 4 Address 4 Warwick Road Wallsend Tyne And Wear NE28 6RT 0191 234 4655 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. Care Home 4 Category(ies) of Learning disability (4) registration, with number of places DS0000000358.V258042.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th July 2005 Brief Description of the Service: The home is registered to provide care for four adults with learning disabilities who may also have physical disabilities. The home does not provide nursing care. The home was purpose built in recent years and provides homely ground floor accommodation. It is situated in the centre of Wallsend and therefore close to all local amenities. It is immediately adjacent to No 2 Warwick Road which provides a similar service. Both homes are run by a private company, Northern Life Care, now known as UBU, which also provides services in other parts of the country. DS0000000358.V258042.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection took place on 28/11/05, between 10.00am and 3.00pm. There is no Registered Manager so relief managers have been managing the service. A new manager is due to commence in December 2005. The relief manager and line manager arrived at the home following the inspectors arrival and request for their attendance. Time was spent looking around the home to check the cleanliness, maintenance and decoration. The service users are unable to express their views about the home and at the time of the visit there were no visitors. Time was also spent observing the contact between the service users and staff. Three Care Plans for service users were examined. Staff described their approaches to caring for the service users. Activities and opportunities for service users to be consulted and access the community were examined. Arrangements for the administration and management of medication were checked. Recruitment, training and protection of vulnerable adults (POVA) were checked. What the service does well: What has improved since the last inspection? The requirements made at the last inspection and additional visit in October 2005 have been met. Arrangements regarding the administration of medication creams have improved. DS0000000358.V258042.R01.S.doc Version 5.0 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. DS0000000358.V258042.R01.S.doc Version 5.0 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 DS0000000358.V258042.R01.S.doc Version 5.0 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 the following standard(s): 2 The needs of service users have been assessed before they were admitted. EVIDENCE: No one else has been admitted in the home since it was registered. Assessments were completed at the time, which looked at the needs and wishes of the service users. DS0000000358.V258042.R01.S.doc Version 5.0 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 the following standard(s): 6 Service users have care plans that have their needs identified but are not being met and which enable them to fulfil their potential. EVIDENCE: Three care plans was examined, staff discussed the activities, which service users like to do. The interactions between service users and staff were observed. Staff spent some of the morning cleaning. One service user was involved in food preparation, which was good. The care plans identify a range of complex needs for each service user. Records and monitoring regarding health care such as food eaten, continence, fluid input and output are incomplete. Service users have special dietary and continence requirements, which must be monitored. DS0000000358.V258042.R01.S.doc Version 5.0 Page 10 One service user has a pressure sore but there was no detail with the monitoring record that identified its location. The district nurse was attending to the pressure sore. A clear care plan exists regarding a pressure-relieving mattress on the bed. Pressure sore prevention assessments are not used in the home i.e. Waterlow. Personal Plans and Ambitions are identified each year but 2005/6 have not been completed or effective. Service users activities and potential for new experiences are not being identified or at times provided. DS0000000358.V258042.R01.S.doc Version 5.0 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 the following standard(s): 11-16 Service users are not fulfilling their personal goals and ambitions. Service users are not always enabled to make decisions about how they spend their leisure time both in the home and outside in the community. Service users are not always engaging in appropriate activities they would enjoy. Service users are able to maintain contacts with family and friends. Service users are not always enabled to communicate. EVIDENCE: When the inspector arrived at 10am the TV and music was on and two service users were sat in the lounge and spent between 10am-1pm with no other stimulation or conversation. One of the service users sat for a long period of time staring out of the window. Daily records state that he often stares out of the window. The care plan identifies that the service user likes to get a newspaper from the local shop and maintain his contact with other people in DS0000000358.V258042.R01.S.doc Version 5.0 Page 12 the community. Records sampled showed that this is not occurring. The weekly plan for the service user is poor and identifies sitting or watching a Video. The service user enjoys his fortnightly contact with his advocate. Staff described the interests of the service user and planned trips to museums and the cinema. The service user sat holding a brochure all morning and became animated when asked by the inspector if it was a holiday brochure. The service user had lunch alone at the dinner table despite having nutritional needs and requiring encouragement to eat. Staff demonstrated that they appear to know the service users well but their contact with the service users was minimal. Staff did not sit down and talk to service users until lunchtime with three of the people. Service users were spoken to as staff walked through the lounge they did not sit down. One of the service users requires 1:1 conversation to develop his speech. Records identified that between 19/11/05 and 27/11/05 that only on 1 occasion did staff use ‘word association’ session as per care plan. During this period on 11 and 12 occasions were spent watching TV or listening to music respectively. Conversation prior to lunch by staff was minimal and did not allow the service user to use a range of words. Closed questions were only asked or staff informed the service user what was going to happen i.e. lie down after lunch. At lunch the service user was enthusiastic and tried to communicate with staff, which they responded to positively. One of the service users who has a sensory impairment normally prefers to get up later in the morning. Staff were attentive to enable her to wake up sensitively and then get her ready as per care plan. The service user had her breakfast at 11.30am and then sat with no stimulation other than the TV and music until 12.30 when she was provided with lunch with staff help. The service user was returned to the lounge again with the TV until staff took her shopping. The service user enjoys going to a hydro bath but from September until the New Year she cannot go because staff forgot to enrol her for the term. Her activity has not been replaced by something else appropriate and different from her normal routine. Although there were no visitors during the inspection it is clear from talking to staff and the care plans that visitors are welcome and plans are in place to maintain contact. DS0000000358.V258042.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 - 20 Service users health needs are not consistently being monitored therefore prevention is not practiced. The medication arrangements have improved so that service users are protected. EVIDENCE: The staff are not consistently monitoring service users health needs, which is recorded in the care plans.(See NMS 6) Routine health checks are carried out and service users attend appointments with relevant health care professionals with staff. Medication arrangements regarding creams were checked and are now dated. DS0000000358.V258042.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Service users are not protected from potential abuse as staff have not all had POVA training yet EVIDENCE: All staff employed at the home require Protection of Vulnerable Adults Training. Training records are incomplete. Some staff undertake awareness training of abuse during NVQ and Learning Disability Award Framework (LDAF) training. DS0000000358.V258042.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Service users live in a home which is appropriate for their needs but some maintenance and cleaning is required. Infection control measures are satisfactory which protects service users. EVIDENCE: The home has a large lounge and dining area which all the service users use. The bedrooms are personalised. Occupational Therapists have reassessed equipment used by the service users. Infection control measures are in place with paper towels and hot water in bathrooms and showers. Antibacterial products are now available and used as per pressure management care plan. The corridor carpet is due to be replaced by end of December 2005 as it is marked and rucked. The bathroom/shower handrail is cracked where it is attached to the wall. The grouting is stained. The shower seat slip mat has black mould. The kitchen was clean and is secured when not in use for the safety of the service users. DS0000000358.V258042.R01.S.doc Version 5.0 Page 16 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32-35 Service users are cared for by staff that are undertaking training in NVQ, LDAF and other appropriate training but some records are not updated or available. Staffing levels required have not been provided to meet the needs of the service users. People who have been vetted care for service users but records must be available in the home. EVIDENCE: Staff training records where checked and some have not been updated. Some records were not available. It is not clear what the content of the fire instruction provided to staff has been. POVA training is planned to be provided and some staff have received awareness training during NVQ and LDAF training but all staff must have training. According to the homes records 33 have achieved NVQ Level 2 or equivalent. - 2 staff have completed NVQ level 2 and 2 staff have commenced NVQ Level 2 training. - 1 member of staff has NVQ Level 3 and 4 staff have commenced NVQ Level 2 training. DS0000000358.V258042.R01.S.doc Version 5.0 Page 17 On the day of the inspection the home had not maintained the level of staffing required to meet the needs of the service users. There were only 2 carers on duty during the day. The required levels of staffing increased 1/8/05 to a minimum of 2 care staff on duty during the day which increases to 3 care staff on duty between the hours of 10am and 6pm and at busy times. At night there must be 1 waking night staff with 1 person sleeping in. Following the last inspection the inspector agreed to the 3rd carer working 10am – 6pm to become 12 –6.30pm but this must now increase on the evidence of this visit and the changing needs of the service users. The Registered Provider and the Manager must keep the levels of staff under review so that they reflect the continuing and changing needs of the service users such as ageing, emotional and safety support Staff recruitment records were examined. Adequate measures are in place when recruiting staff. Checks are made including the Criminal Records Bureau. However a newly recruited member of staff’s records were not available in the home. Records were faxed from the organisations Headquarters in Harrogate. A photograph was not available. There is no evidence that staff have received the General Social Care Councils Code of Conduct. DS0000000358.V258042.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,41 & 42 A registered manager must manage the Service users care and welfare. Registration records must be maintained so that service users are protected. EVIDENCE: Some of the service users are aged over 65 years and so an application must be made to vary the homes condition of registration to reflect this. CSCI sent out the appropriate forms following the inspection. The new managers hours must be 32 hours off the staff rota (supernumery) and 8 hours working as part of the staff team on the staff rota to improve the service. The new manager must also apply to be registered. Health and safety checks are maintained and equipment serviced. DS0000000358.V258042.R01.S.doc Version 5.0 Page 19 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 3 X X Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X 3 LIFESTYLES Standard No Score 11 2 12 2 13 2 14 2 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score X 2 1 2 2 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 1 3 X Standard No 37 38 39 40 41 42 43 Score 1 X X X 2 3 X DS0000000358.V258042.R01.S.doc Version 5.0 Page 20 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 Requirement Service users must be consulted about their lives and have access to appropriate activities in and outside of the home. The healthcare of service users must be identified and monitored ie input/output/nutrition, continence, pressure sore areas. Repairs/cleaning must be made to the damaged handrail, stained shower slip mat seat and groating to tiles near shower. The Registered person shall ensure that at all times suitably qualified, competent and experienced persons are working at the care home in such numbers as are appropriate for the health ands welfare of service users. Records required for Version 5.0 YA14YA13YA12YA11YA6 15 Timescale for action 28/11/05 2 YA19 12 28/11/05 3 YA24 23 17/12/05 4 YA33 18 28/11/05 5 YA34 17 31/12/05 Page 21 DS0000000358.V258042.R01.S.doc 6 YA23YA35 18 inspection must be available in the home and a photograph of staff provided until an agreement with CSCI is put in place. All staff must receive training in Protection of Vulnerable Adults. The content of Fire Instruction and attendees must be recorded. 31/01/05 7 YA37 10 8 YA41 12 & 17 Training records must be available and up to date. A new Manager must 17/12/05 apply to be registered. The majority of the manager’s hours (32) must become supernumary. An application for a 31/12/05 variation of registration to reflect the change in the numbers of people (2) who have a Learning Disability aged over 65 years LD (E). 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 2 Refer to Standard YA32 YA34 Good Practice Recommendations A minimum ratio of 50 of care staff qualified to NVQ Level II or equivalent must be achieved by 2005. Staff should receive a copy of the General Social Care Councils Code of Conduct. (provide evidence of receipt) DS0000000358.V258042.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Cramlington Area Office Northumbria House Manor Walks Cramlington Northumberland NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI DS0000000358.V258042.R01.S.doc Version 5.0 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. 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