Inspection on 13/11/08 for 30 Vicarage Road

This inspection was carried out on 13th November 2008.

CSCI found this care home to be providing an Good service.

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

30 Vicarage Road 06/12/06

30 Vicarage Road 26/01/06

30 Vicarage Road 16/09/05

30 Vicarage Road 01/03/05

30 Vicarage Road 21/09/04

30 Vicarage Road 25/11/03

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Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 30 Vicarage Road 30 Vicarage Road Rugby Warwickshire CV22 7AJ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Justine Poulton     Date: 1 3 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 27 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 27 Information about the care home Name of care home: Address: 30 Vicarage Road 30 Vicarage Road Rugby Warwickshire CV22 7AJ 01788547781 01788573410 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: New Directions (Rugby) Ltd care home 6 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 30 Vicarage Road is a large town house in a residential area close to the town centre of Rugby. It provides residential care for six people with learning disabilities and low care needs. The house is staffed by one person the majority of the time when people are at home. Day services are not routinely provided at the house but people can have days at home if they wish. The ground floor consists of two lounges and a large dining/ kitchen area. There are two upper floors, each with a bathroom. The six single bedrooms and one sleep in room for staff are divided between the first and second floors of the house. There is a courtyard at the rear and a range of outhouses. 6 Over 65 0 Care Homes for Adults (18-65 years) Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was carried out to establish the outcomes for people living in this home and to confirm whether they are protected from harm. Identified key standards were looked at along with a review of the organisations progress towards meeting any requirements made at the previous inspection of this service. The pre fieldwork inspection record was completed as well as a site visit to the home during which time staff, people living in the home and the manager were spoken with. A completed annual quality assurance assessment was received from the service prior to the inspection. Surveys were sent out to the people living in the home and a sample of key Care Homes for Adults (18-65 years) Page 5 of 27 stakeholders. Sixteen were returned. These were all generally positive, however there were comments that more staff on duty would be beneficial. Other comments in the surveys received included It is a secure and well run home that has a happy and comfortable feeling, my relative is very happy in her surroundings, excellent, a good home, I like living here with my friends, I chose to move here, I am happy living at Vicarage Road. Two people were identified for close examination by reading their care plans, risk assessments, daily records and other relevant information. This is part of a process known as case tracking, where evidence is matched to outcomes for service users. Records, policies and procedures and other relevant information were examined and the environment was looked at. Most of the people living in the home were at home for part of the inspection. What the care home does well: What has improved since the last inspection? Since the last inspection of this home which took place on 6th December 2006, work has been undertaken to ensure that the requirements made have been met. - Documentation looked at during this inspection confirmed that peoples care planning information is now reviewed on an regular basis and updated as necessary. Care Homes for Adults (18-65 years) Page 7 of 27 - Risk assessments have been carried out and are reviewed regularly and updated as necessary. - Medication is managed safely on peoples behalf. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective people to the home can be confident that their needs will be assessed. Evidence: No one new has moved into the home since the last inspection which took place in December 2006. This key standard is deemed to be not applicable on this occassion. Information was available to confirm that the home has an admissions policy in place however should a vacancy arise in the future. Care Homes for Adults (18-65 years) Page 10 of 27 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning programmes and risk management strategies in place continue to ensure that staff are fully equipped with all the necessary information to meet peoples assessed and changing needs. People are supported to make decisions about their lives. Evidence: Two people were chosen for case tracking. Examination of their care planning documentation confirmed that they were comprehensive in their detail and provided staff with relevant information to best meet peoples assessed needs. The information provided was also current as records looked at confirmed that they were reviewed routinely on a 6 monthly basis. The manager of the home has been proactive in supporting people who do not communicate verbally to become involved in their review process by creating a photographic invitation to an annual assessment that shows the person using the relevant Makaton signs. This is to be commended as extremely good practice. Care Homes for Adults (18-65 years) Page 11 of 27 Evidence: Both people also had a series of current risk assessments in place that were reflective and supportive of their care plans. These included things such as bathing, personal care, kitchen safety, fire, healthcare, stranger danger, family contacts, travel, road safety, water safety and refusal of medication. These were all signed and dated, with ongoing evidence of reviews also recorded. Information available and observation demonstrated that the people who live in the home are fully supported with making decisions about their lives. Choices consultation forms in place that demonstrate that people are listened to and their requests actioned. Similarly, when people began arriving home from their daytime activities they were comfortable in making drinks, making requests of the staff and appeared very comfortable in their surroundings. Care Homes for Adults (18-65 years) Page 12 of 27 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to be supported and encouraged to participate in age, peer and culturally appropriate activities. People have regular contact with family and friends. A wholesome and nutitious diet that takes into account peoples likes and dislikes is encouraged. Evidence: Everyone that lives in the home attends a formal day placement of some sort, be it at New Directions, local authority day centres, a farm, work or at college. The two people case tracked attend the New Directions day service either full time or part time, with one person also opting to maintain links at her local authority day service. In addition to their more formal daytime placements the staff at the home support people to make use of both the local and wider community through visiting the cinema, local pubs and restaurants; the library, local places of worship, parks and shops. An annual holiday is Care Homes for Adults (18-65 years) Page 13 of 27 Evidence: also facilitiated and both people case tracked had been to the Canary Islands for a holiday earlier in the year. The home continues to function on a domestic basis. As such there are no set routines in place other than those imposed by the people who live there. The home has a kitchen diner that has recently been refurbsihed with new units. It was well stocked with plenty of fresh, frozen and processed foods. During the inspection preparations for a birthday party were underway, with lots if tasty looking buffet foods being cooked. The home continues to maintain the folder that contains all of the necessary information on kitchen protocols and health and safety. Care Homes for Adults (18-65 years) Page 14 of 27 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care planning documentation continues to ensure that personal support is consistent, reliable and responsive to peoples changing needs. The healthcare needs of people continue to be assessed and recognised with evidence of specialist services being readily available to them as necessary. Medication is managed safely on peoples behalf. Evidence: There was clear information within the two peoples files looked at regarding the assessed levels of personal care and support required. This information was informative and detailed and ensured that staff providing support were clear in the tasks they were undertaking or the prompts that they were offering. Peoples healthcare needs continue to be monitored by the home, and it was easy to see the schedule of routine healthcare appoinments attended. There was also clear information to confirm that more specialised heathcare needs are addressed as necessary. Care Homes for Adults (18-65 years) Page 15 of 27 Evidence: At the time of the inspection none of the people living in the home were responsible for administering their own medication, although this was being looked into for one person. Medication continues to be supplied to the home by Boots in a multi dispensing system (MDS) which is accompanied by medication administration records sheets. One anomally in the recording of a liquid medication was discussed with the manager and house leader, who undertook to talk to the staff about their recording methods at the earliest opportunity. No other anomalies were noted with medication administration and procedures at the time of the inspection. Medication was stored in a locked wall mounted cabinet in the office/quiet room of the home. A separate locked cupboard was available to store controlled drugs should they be prescibed. Training records confirmed that all staff have received training in the safe administration of medication. Care Homes for Adults (18-65 years) Page 16 of 27 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home continues to have satisfactory policies and procedures in place for responding to complaints and safeguarding vulnerable adults, that evidence that peoples views are listened to and acted upon. Evidence: The home continues to abide by the organsiations complaints policy and procedures. People who live in the home have been provided with copies of this. Information contained in the completed surveys returned by both relatives and the people living in the home indicated that they are all aware of how to make a complaint. It is recorded in the annual quality assurance assessment completed by the manager prior to the inspection, that the home has not received any complaints in the last 12 months. Simiarly we have not received any complaints about the home. The home also has a policy on safeguarding vulnerable adults in place. It also abides by the Warwickshire joint agency protocol on safeguarding vulnerable adults which is led by social services. The manager advised that there have been no suspicions of or incidences of abuse in the last 12 months. Training records looked at indicate all staff have received recent training in safeguarding vulnerable adults. The organisation has recently undertaken a thorough audit and overhaul of how peoples monies are managed. The manager talked through this process. The monnies Care Homes for Adults (18-65 years) Page 17 of 27 Evidence: of the two people chosen for case tracking were checked and were accurate, with recordings in place that matched the process as explained by the manager. Care Homes for Adults (18-65 years) Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People continue to live in a domestic, comfortable, homely environment that promotes ordinary living. Evidence: The home is a large three storey house in a residential area of Rugby, close to the town centre. The ground floor consists of one lounge, a quiet room/office and large dining area with kitchen. The kitchen has recently been refurbished with new units. There are two upper floors, each with a bathroom. The six single bedrooms and one sleep in room for staff are divided between the first and second floors of the house. The communal areas of the house have all been decorated in the last twelve months and were bright, light and airy, creating comfortable spaces for people to spend their time. The furniture and soft furnishings throught the home were of a good quality. The home has a cleaning rota in place which has been drawn up by the people that live there to ensure that they all take an equal responsibility in keeping their house clean. One person spoken with clearly had great pride in his home and spoke about the chores that he does on a daily basis. Care Homes for Adults (18-65 years) Page 19 of 27 Evidence: Infection control procedures are in place and adhered to. Care Homes for Adults (18-65 years) Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The people who live in this home continue to be supported by a caring and competent staff team. Staff recruitment procedures continue to ensure that people are safeguarded. Evidence: The home employs a house leader and three support staff on a variety of hours to support the people that live there. The manager is based in the home, but also has responsibility for another small service within the organsiation. There is generally one member of staff on duty at any one time. Of the ten completed surveys returned by staff and relatives, half commented that there were not enough staff on duty to enable sufficient one to one time with people or spontaneous participation in external activities. Support staff undertake all of the caring and domestic chores in conjunction with the people who live there in order to promote their independance. Two staff files were looked at, one of which was for a person who commenced work in February of this year. All of the documentation necessary to demonstrate that people are safeguarded through robust recruitment were in place. Training records were in place for all four staff members. Two of these were sampled, Care Homes for Adults (18-65 years) Page 21 of 27 Evidence: and confirmed that they have completed all of the necessary mandatory training within the last 12 months. Other training completed included diet and dietary needs, the mental capacity act, infection control, makaton, principles of care and the learning disability qualification. In addition to the inhouse training undertaken by staff, they are also registered on or have completed the learning disability induction and foundation courses. Two staff have also completed their NVQ III. Care Homes for Adults (18-65 years) Page 22 of 27 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is managed by a suitably experienced and qualified manager. The systems in place for monitoring the quality of the service ensure that peoples views are at the forefront of service delivery. Health and safety is maintained. Evidence: The organsiation has reorganised its management structure since the last inspection of this home, and has appointed a new registered manager to the service. This person has worked for the organisation for some considerable time and has a wealth of experience in working with people with learning disabilities. She has also completed the necessary NVQ 4 and registered managers awards. The manager is supported by a competent house leader who has also successfully completed her NVQ 4 qualification. As well as Vicarage Road, the manager also holds management responsibility for another of the organsiations small homes. She said that she bases herself at Vicarage Road however. Staff spoken with and comments made in the surveys received indicate that the manager is approachable and has already made positive improvements to the way the home functions. Care Homes for Adults (18-65 years) Page 23 of 27 Evidence: The organsiation has an annual commitment to assessing the quality of the service it provides to people via an anual quality audit. The last of these was undertaken early in 2007. The manager said that work has been undertaken on improving the questionnaires that are used in these surveys, and these will be going out to the people living in the home and other key stakeholders before the end of December 2008. A sample of health and safety records were checked, which included fire alarm system testing, portable appliance testing and the electrical installation certificate. These were all current. The Gas safety record was out of date however, having expired on 25th October 2007, and requires renewing. This was discussed with the manager at the time, who undertook to chase it up. Care Homes for Adults (18-65 years) Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 32 It is recommended that the manager review staffing levels to ensure that people have access to support when they want it. Care Homes for Adults (18-65 years) Page 26 of 27 Helpline: 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 We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 27 of 27 - 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!