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Inspection on 23/08/05 for 33 Blanford Road

Also see our care home review for 33 Blanford Road for more information

This inspection was carried out on 23rd August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home provides detailed care plans for each service user, two were sampled by the Inspector and were found to contain clear information that would assist staff in ensuring they met the needs of the service users. A new resident spoke highly of the staff team and the process of moving home and settling in.

What has improved since the last inspection?

The majority of the requirements made had been met by the organisation and those outstanding were in progress. The delay had been due to the need for planning and finances to be put in place. These areas have been noted in the report. A new freezer has been bought and will assist staff in keeping the item clean. In addition staff have been provided with an alcohol hand wash to further reduce the risk of cross infection.

What the care home could do better:

The Inspector was concerned at the delay in providing staff with training in Makaton. A specified service user uses Makaton to communicate and the home`s statement of purpose notes that it supports people with complex needs and communication difficulties. The training is now in the planning stage and staff are awaiting dates for the training. A requirement was made at the inspection on the 24th August regarding the recording and storage of medication, this is noted in more detail within the report.

CARE HOME ADULTS 18-65 Blanford Road 33 33 Blanford Road Reigate Surrey RH2 7DP Lead Inspector Mrs Susan McBriarty Unannounced 23 August 2005 rd 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. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 33 Blanford Road Address 33 Blanford Road Reigate Surrey RH2 7DP 01737 243818 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) Prospect Housing and Support Services Mr Anthony Berner Care Home 6 Category(ies) of LD - Learning Disability (4) registration, with number of places LD(E) - Learning Disability over 65 (2) PD - Physical Disability (1) PD(E) Physical Disability over 65 (1) Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 8. The age range of service users falling within catergories LD(E) or PD(E) is 65 years and over 2. Of the four residents within category LD, up to 1 may also fall within category PD (physical disability) 7. The age range of service users falling within the categories LD or PD is 40 64 years 6. Of the two residents within the category LD(E), up to one may also fall within category PD(E) Date of last inspection 26th April 2005 Brief Description of the Service: 33 Blanford Road is a detached bungalow located in the town of Reigate. The home is registered for six adults with both learning and physical disabilities. the home is owned and managed by Prospect Housing Association. Service users have their own individual bedroom and share adequate bathroom, toilet and shower facilities. The combined lounge and dining room are domestic in character with views over a nicely and well-stocked large enclosed garden. Furniture in the lounge is sufficient and can accomodate all the service users including those in wheelchairs. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the second inspection for 2005-2006.For a fuller picture of the home please see previous inspection reports. This inspection focussed on those Standards not assessed at announced inspection of 26th April 2005. During the course of the inspection the Inspector spoke to one service user and two members of staff. Documents sampled by the Inspector included medication administration records, the statement of purpose, service user contracts and financial records. The requirements made at the last inspection were discussed with regard to progress and outcomes are noted within the report. What the service does well: 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. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 6 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 Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 7 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) 1,5 Standards 2,3, and 4 were assessed on the 26th April 2005. The home has a statement of purpose and has regard for the communication needs of the service users. The contract provided by the home is a tenancy agreement and is not in plain English. EVIDENCE: The home has a statement of purpose however it would be difficult for the service users to understand the content of the documents. The statement is held in a large lever arch file and contains copies of the contract, complaints procedure and other information required. The service user files have clearer information for service users including the service user guide. The service users have complex needs and communication difficulties and the home seeks to ensure that information is provided in an alternative format. A recommendation is made that the organisation seek to provide the statement of purpose in a more accessible format for the service users taking into account their needs. The contracts provided by the organisation are tenancy agreements and the CSCI are seeking advise on the content to ensure that they meet The National Minimum Standards Young Adults. No requirements have been made in relation to the contracts from this inspection. The organisation will be advised should this be necessary. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 8 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) Standards 6,7,8,9,and 10 were assessed on the 26th April 2005. EVIDENCE: The requirement made on the 26th April 2005, that care plans record clearly if a service user is not able to sign their own care plan or risk assessment has been met. The home has also noted where they intend to ask Care Managers to sign care plans. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 9 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 Further work is required by the home to ensure that this Standard is fully met as training is required to ensure staff can meet the communication needs of the service users. Standards 12,13,14,15,16 and 17 were assessed during the announced inspection of 26th April 2005. EVIDENCE: As noted previously in the report training is now planned for staff regarding the use of Makaton this will assist the home in ensuring that they are able to meet specific communication needs. Specialist services are provided as required and was evidenced in discussion with the deputy manager and specific service user information. The pre-admission reports and care plans sampled noted the spiritual needs of the service users. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 10 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) 20 Further work is required to ensure that the homes records and storage of medications meet the National Minimum Standards Young Adults. Standards 18,19 and 21 were assessed at the announced inspection on the 26th April 2005. EVIDENCE: The Inspector sampled a number of medication administration records and gaps were present, medication that should have been stored in the controlled medication cupboard was found in the non-controlled medication cupboard and in a number of instances the second signature was not present. The second signature is a check required by the organisation to reduce the risk of errors in administering medication. The home does not have a controlled medication book in use. A requirement is made that the home reviews the procedures for the storage, handling, recording and administration of medication. The Inspector noted that the information provided regarding the amount of medication at the home was correct and that procedures are in place to reduce the risk of error. The home had investigated the issues regarding medical consent and had added information provided through the local guidelines for the protection of vulnerable adults. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 11 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) Standards 22 and 23 were assessed at the inspection on the 26th April 2005. EVIDENCE: Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 12 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) Standards 24,25,26,27,28,29 and 30 were assessed at the inspection on the 26th April 2005. EVIDENCE: The requirement made at the last inspection has been progressed. The Inspector was informed through telephone calls to senior managers and the maintenance department made by the deputy manager that tenders for the redecorating have been sent out. The home staff members have requested a catalogue in order that a decision can be made regarding what colour and style of furniture they wish to purchase for the living and dining areas. The requirement made at the inspection on the 26th April is met. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 13 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) Standards 31,32,33,34,35 and 36 were assessed at the inspection on the 26th April 2005. EVIDENCE: The requirement that CRB records are held at the home has been met by the recording and keeping of information regarding staff names and disclosure numbers at the home. The list seen by the inspector was said by the deputy manager to be up to date and correct. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 14 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) 43 Standards 37,38,39,40,41 and 42 were assessed at the inspection on 26th April 2005. The organisation undertakes quality assurance monitoring and insurance cover is up to date. EVIDENCE: The Inspector was provided with a copy of the business plan and has requested that a copy of the financial plan be forwarded to the CSCI once complete. The deputy manager stated that the organisation undertake a quality assurance process that includes service users. The CSCI have requested a copy of the process and outcomes. The insurance document was seen by the Inspector who noted the renewal date is in early September 2005, the deputy manager informed the Inspector that the organisation has already advised that replacements are being forwarded to the home shortly. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 15 The requirements made at the previous inspection including the provision of paper towels and liquid soap has been met. In discussion with the CSCI it was agreed that staff members would be provided with a portable alcohol hand wash for use in the home, this recommendation has been completed. A new freezer has been purchased for use by the home. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 16 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 3 x x x 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 3 x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Blanford Road 33 Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x 2 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 17 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 20 Regulation 13(2) Requirement The registered person must ensure that the arrangements for the recording, handling, safekeeping, safe administration and disposal of medications into the home are reviewed. The registered person must ensure that a controlled medications book is in use within the home. The registered person must forward a copy of the organisations quality assurance document including outcomes. The registered person must forward to the CSCI a copy of their financial plan. Timescale for action 9th September 2005 2. 20 13(2) 9th September 2005 30th September 2005 30th September 2005 3. 43 24 4. 43 25(1)(2) 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 1 Good Practice Recommendations It is strongly recommended that the statement of purpose be provided in an accessible format. Blanford Road 33 H58 s13487 Blanford Road v236974 230805 stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN 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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