Inspection on 02/11/05 for 32 Albert Road

This inspection was carried out on 2nd November 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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

32 Albert Road 29/06/09

32 Albert Road 08/08/06

32 Albert Road 04/05/05

32 Albert Road 02/12/04

32 Albert Road 26/06/04

32 Albert Road 01/05/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 32 Albert Road Clevedon North Somerset BS21 7RT Lead Inspector Nicola Hill Announced Inspection 2nd November 2005 10:30a 32 Albert Road DS0000020233.V254262.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 32 Albert Road DS0000020233.V254262.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. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 32 Albert Road Address Clevedon North Somerset BS21 7RT 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) 01275 341753 0117 9699000 The Brandon Trust Ms Nancy Ruth Kitson Care Home 9 Category(ies) of Learning disability (9), Physical disability (9) registration, with number of places 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. May accommodate up to 9 persons aged 18 years and over with learning difficulties and may also have a physical disability. Staffing Notice dated 17/03/1999 applies. Manager must be a RN on part 5 or 14 of the NMC register. Up to four residents may be accommodated for respite care on the ground floor. The maximum duration of respite should be one month. One named permanent resident may continue to reside on the ground floor. This will lapse when the resident leaves the home. Up to five permanent residents may be accommodated on the first floor. As vacancies arise the existing double rooms should be used for single occupancy. An additional bathroom should be provided for use by permanent residents by 1/11/03. 4th May 2005 5. 6. Date of last inspection Brief Description of the Service: The Lodge nursing home is part of the Brandon Trust, and offers care and support services for people with learning disabilities and physical disabilities. It is a small home with capacity for nine residents. The service currently provides for six older people who have been resettled from long stay institutions. The home also provides a respite service for up to three younger people in the North Somerset area. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. On the day of the announced inspection, there were no service users using the respite service during the day, as they were out of the home at day centres/colleges. The inspector briefly met two service users when they returned from the day centre, both of who were familiar with the staff team and appeared happy to be using the service. The manager distributed comment cards to respite service users and their families, the comments received were generally positive about service. One carer has raised specific issues, which have been discussed with the manager. The manager is working with North Somerset Council in developing an alternative short break provision. North Somerset Council does not wish the respite service to continue in its present form, and wish to set up a new service in the Weston area. They wish to commission a planned short break provision of a three beds, with an annex (one bed) to provide an ad hoc intensive support service. This service is currently at the planning stages, and the manager is aware that any new provision would need to be registered, meet the environmental standards for new services, and be staffed sufficiently to ensure service user and staff safety in respect of the intensive support service. The respite service at The Lodge will be closed from 24 December 2005 until the first of January 2006. No staff will be rota’d to cover the service. What the service does well: From the comments received the service at the Lodge provides flexibility for families and service users. Staff were identified as always being very helpful; and relatives expressed their satisfaction with the care provided. The staff establishment of the home now has flexibility to ensure that the service users can be fully supported to attend their usual daytime activities whilst on respite. The staff levels reflect the support needed by the service users, especially where one-to-one support is required. The provision for the respite service is separated from the residential service, but if service users wish to integrate then this is facilitated by staff and group activities are planned. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 32 Albert Road DS0000020233.V254262.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 32 Albert Road DS0000020233.V254262.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): 4 The home makes ensures that prospective service users to the respite service can visit the home. EVIDENCE: The manager was able to demonstrate that all of the service users referred to the home have the opportunity to visit and meet the staff prior to staying there. The procedure for all new referrals is that they can have a drop-in visit with their relative/carer and stay as long as they wish to. This is repeated until the service user feels comfortable visiting the home; visits can then be extended to cover a meal, an activity or an overnight stay. The manager ensures that good communication is established with relatives and carers so that any problems encountered are discussed and action taken to prevent further issues. 32 Albert Road DS0000020233.V254262.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 There is a clear and consistent care planning system in place to meet individual needs and aspirations. EVIDENCE: The care files for the respite service users all contain detailed care plans that have been formulated through the care managers and in consultation with service users and their carers/relatives. From the information provided the manager and staff team at the Lodge are able to identify and plan to meet the support needs of each individual. When the care plans are reviewed by the care managers or because of changing need, staff from the lodge are invited to share information. Some of the service users are infrequent visitors and may only have one holiday a year at the lodge. In these cases it is important that the manager ensures that the information provided from the care manager is the most up to date, and that any changes to the support needs of individual are known before admission. In respect of other service users who attend more frequently, it should be possible for the staff team to work with other service providers to produce person’s centred plans, which reflect the individuals chosen lifestyle. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 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 the following standard(s): 11,15 &17 The residents have a very full and varied life that is dictated by the demands of the programme. EVIDENCE: Service users are able to access varied activities; links with the community are good and staff support service users access to social and educational opportunities. The meals offered are the same as those given to the permanent residents, which are planned to incorporate known choices and preferences. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 11 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 The health care needs of service users are identified and met in a professional manner. EVIDENCE: The personal care support for each individual is identified and known to the staff team. The service users are treated as temporary residents and have their primary care needs met by the local GP practice, and specialist care needs met by the CLDT. The individual personal files have information on them indicating that the health care needs of individuals is monitored and any action needed is taken. For example, the trained nurses have care protocols in place to deal with anticipated emergencies i.e. epileptic seizures, and they must be able to demonstrate that they have responded in an appropriate manner in discharging their duty of care toward the service user, and within their professional accountability. At the time of the inspection there was no medication on the premises for any respite service users. The staff team ensure any medication brought in is recorded and counted; the medication is booked out on discharge. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 12 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): 22 Some service users are able to self-advocate and raise concerns or complaints; however all service users have an advocate. EVIDENCE: The complaints procedure for the Brandon Trust is in place at the home, no complaints had been received since the last inspection. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 13 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 The Lodge is an old building that requires ongoing maintenance and investment. EVIDENCE: The inspector did not tour the building however, there is a welcoming first impression and the respite provision of the home was clean, comfortably furnished and free from unpleasant odours. There is an issue with the secondary glazing for the sash windows, which has a tendency to fall shut when it has been opened. The manager was advised to assess the risk and identify any temporary action that could be taken to make this safe, whilst the Trust are deciding on the permanent action to remove the risk. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 14 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): 32,36 There is an established staff team at the home who have a very good understanding of the service users support needs, and are able to provide a continuity of support. EVIDENCE: The inspector was able to talk with several members of staff during inspection, only one of which was very new to the home. The reduction in the number of vacancies in both trained staff and home support workers have been beneficial in that trained staff are able to take delegated tasks from the manager. There is also the opportunity to work closely with service users, to identify suitable communication systems to support service users to express choice and make decisions. The Trust is supporting staff team with training appropriate to the support needs of the service users. The staff are receiving regular supervision and attending staff meetings, both of which were identified as being opportunities for staff and team development. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 15 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): 37,39,42 The manager is supported by senior staff in providing clear leadership in the home with staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: The staff morale at the home appears to be high; all the staff that spoke with the inspector were very positive and enthusiastic about working at The Lodge. The staff recognise that respite provision was an opportunity to learn new skills, and work in a more proactive role with younger adults. The manager was observed to have a good relationship with the staff team, and stated her appreciation and satisfaction with the care provided by them to the resident group. The proposed changes for the service were discussed, but currently there are no firm plans for alternatives. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 16 The respite service users are not actively consulted about the day-to-day running of the home, although feedback is received regularly from relatives/carers. There is an expectation that the service users will be or have been consulted about the proposed change in service provision. This process should include families and carers. The implementation of health and safety at the home in respect of the safety and welfare of the service users was satisfactory accepting the environmental issues as detailed earlier in the report. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 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 3 X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X X X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 32 Albert Road Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X X X DS0000020233.V254262.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? No 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 YA24 Regulation Requirement Timescale for action 02/01/06 13(4)(a)(c) The secondary glazing must be safe to use for staff and service users. 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 YA6 YA39 Good Practice Recommendations The manager could review how they work with other service providers to produce person centred plans to support service users to achieve their chosen lifestyle. The service users, families and carers should be consulted about the proposed change in service provision. 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 32 Albert Road DS0000020233.V254262.R01.S.doc Version 5.0 Page 20 - 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!