Inspection on 06/12/05 for 34 Ceely Road

This inspection was carried out on 6th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

34 Ceely Road 15/12/08

34 Ceely Road 18/03/08

34 Ceely Road 26/09/06

34 Ceely Road 27/06/05

34 Ceely Road 04/05/04

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

CARE HOME ADULTS 18-65 Ceely Road (34) Aylesbury Bucks HP21 8JA Lead Inspector Barbara Mulligan Unannounced Inspection 6th December 2005 10:30 Ceely Road (34) DS0000023048.V271791.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 Ceely Road (34) DS0000023048.V271791.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. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ceely Road (34) Address Aylesbury Bucks HP21 8JA 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) 01296 485756 www.macintyre-care.org MacIntyre Care Mrs Penny Cummings Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: 34 Ceely Road is a large, two storey, detached modern house located within a residential area of the market town of Aylesbury and is close to Stoke Mandeville Hospital. It is home to six younger adults with learning disabilities. The home has six single bedrooms on the upper floor and has a secure maintained garden which is accessible to all service users. The home is situated close to Aylesbury and local amenities that include shops, cinema, pubs and restaurants. Public transport is available and accessible to service users living in the home. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 6th December 2005 at 10.30am. The visit consisted of discussions with the senior carer on duty, a tour of the home and records, and policies and procedures were examined. The inspection officer was Barbara Mulligan. On the day of the inspection most service users were out undertaking day care services or leisure activities. What the service does well: What has improved since the last inspection? What they could do better: Staff files, or evidence of appropriate recruitment procedures are not available in the home for newly appointed staff members. This is a requirement of the report. An effective quality assurance system needs to be implemented to ensure the views of service users are taken into account. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 6 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. Ceely Road (34) DS0000023048.V271791.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 Ceely Road (34) DS0000023048.V271791.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): 1, 2, 3, 4 and 5 The homes Statement of Purpose and Service Users Guide provide service users and prospective service users with details of the services the home provides. Pictorial guidance is included to make both documents suitable for the people for whom the home is intended. Service users needs are thoroughly assessed prior to admission ensuring that staff are prepared for admission and have a clear understanding of the service users requirements. The opportunity to visit the home prior to admission is an integral part of the admission process, which means that service users are orientated to the environment and have met and are familiar with staff and other service users beforehand. Prospective service users have the opportunity to visit the home on an introductory basis, before making a decision to move there, ensuring that service users are able to make an informed choice about where they live. Each service user has an individual written statement of terms and conditions with the home that is signed by service users or ensuring the rights of service users are protected. EVIDENCE: Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 9 The Service Users Guide is well presented and informative and this document covers all the necessary information as detailed in Standard 1. The Statement of Purpose contains all the necessary information as detailed in Schedule 1. The assessment tool used by the home is called “Moving into Macintyre Care” and is very comprehensive and detailed. This is dated June 2003. Pictures are included alongside written information to enable the potential service users to understand the process. The home has a policy called “Moving in and Moving out guidelines”. This is dated June 2003. This gives details of trial visits to the home, day-to-day support service users can expect and details of how and when a review of the placement will occur. The inspector looked at service users contracts/statements of term and conditions. These cover all areas detailed in Standard 5 and are signed by either service users or their representative. The home does not take emergency admissions nor is intermediate care offered. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 10 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, 7, 8, 9 and 10. Clear and consistent care planning systems are in place that provides staff with adequate information they need to satisfactorily meet service users needs. Service users make decisions about their lives, with assistance and communication support, that allows them to influence their lifestyle and how the home is run Service users are supported to take responsible risks within the context of the home’s risk assessments and risk management strategies that ensure service users can have independent lifestyles. Personal information is handled appropriately ensuring that personal confidences are respected. EVIDENCE: Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 11 Care plans are informative and comprehensive, covering a wide range of needs. Each file contains a pen picture, health check records, information regarding family/friends, medical information, daily routines and likes and dislikes. There is evidence that the care plans are working documents and that changes to care plans are made when the changing needs of service users warrant it. Service user plans identify the changing needs and personal goals for each individual. Each file is well organised and user friendly. Risk assessments are in place with regard to service users who are unable to self-administer their own medication, service users who can or cannot manage their own money, swimming, horse riding, service users activities, road safety and household tasks. Service users families are involved in the care-planning process if the service user wishes them to be. The home operates a key worker system. Service users are given opportunities to make decisions about their lives, with assistance as needed. This includes help to make decisions regarding their choice of activity, daily routines, menu planning and preferred daily routines. Different methods of communication are used to assist the service users when making a choice. These are varied and individual to each service user. Minutes of the latest service users meetings are pinned up on a notice board and displayed in symbols so service users can understand its contents. Efforts to improve communication with service users are to be commended. Service users are offered opportunities to participate in the day-to-day running of the home as far as they are able to. Guidelines regarding missing persons and a range of individual risk assessments are in place. Service users records observed by the inspector are accurate, secure and confidential. Training in confidentiality is covered during staff induction and information regarding confidentiality is contained in the staff notes dated 26/09/2002 and there is a Public Interest Disclosure Policy. The service users of the home are unable to manage their own finances, and these are managed by the registered manager and care staff. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 12 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): 12, 14, 16 and 17. Service users are able to access a wide range of amenities which meet their social, leisure and spiritual needs. Service users engage in appropriate leisure activities inside and outside of the home, allowing individuals to pursue their own interests and hobbies. Service users rights are respected and the daily routines of the home promote individual choice and freedom of movement. Service users are supported to develop their own menus and participate in some cooking tasks, which promotes independence and choice while at the same time reinforcing independent living skills. EVIDENCE: Service users are given opportunities to maintain and develop social, emotional, communication and independent living skills and there is evidence of this in service user plans. Service users can access literacy and numeracy training, colour recognition and other further education courses via day care services. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 13 Care plans show that service users are encouraged and supported to pursue their own interests and hobbies. Examples of these are the cinema, horse riding, swimming and shopping. One service user has recently taken up golf as a leisure pursuit. Where necessary, appropriately trained staff support and advice the service users. Each service user has access to a television and music systems. Service users enjoy an annual holiday. All bedrooms have a lockable facility and one service user access’s this facility. Service users are supported to open their own mail. Staff assist service users with reading and understanding the content of their mail, if help is required. Preferred terms of address are recorded in service user plans. Interaction between staff and service users is carried out with respect and in a manner that is appropriate to service users. Staff are to be commended on their approach to service users. At the time of the inspection there are no service users who smoke. MacIntyre Care has a smoking policy in place. Service users choose their own menus at weekly house meetings. Meals are offered three times a day and service users have access to snacks and drinks throughout the day. A record is kept of all meals provided. Some support is needed by service users to ensure healthy eating and they have access to the dietician. All service users are weighed regularly and weights are recorded. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 and 21. The physical, emotional and health care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The systems for the administration of medication are well managed protecting service users and ensuring their medication needs are met. There are good policies/procedures in place to ensure that the ageing, illness and death of a service user will be handled with respect and as the individual would wish. EVIDENCE: Information regarding personal care is recorded in service user plans. Service users are able to choose the times they wish to go to bed, bath, have their meals and take part in other activities. It is also evident through reading care plans that clothes, hairstyles, make up and appearance is the service users choice. The home operates a link worker system. The care plans set out in detail the service users preferred routines, likes and dislikes and partnerships with families, friends and relevant professionals outside of the unit. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 15 Service users are supported and facilitated to manage their own healthcare where practicable. Visits to service users by health care professionals take place in the privacy of their own rooms. All service users have an annual health check. There is evidence in care plans that service users attend the opticians and hearing assessments on an annual basis and regular chiropody and dental appointments. Additional support is accessed through the Learning Disabilities Community Team, where service users can access physiotherapists, occupational therapists, speech therapists and other specialist service they may require. None of the service users in the home are able to self-administer their own medication. At the time of the inspection the supplying pharmacist was undertaking a visit to the home to complete a three monthly inspection. The inspector joined the pharmacist for his visit to the home. Records show all medication received, administered and leaving the home, or disposed of. It is pleasing to note that there are no omissions. No controlled drugs are in use. There are guidelines regarding the death of a service user and this is dated April 2004. These include the expected, sudden or unexpected death of a service user and a last wishes questionnaire. If a service user becomes ill, an assessment will be carried out with the involvement of their family, and the service users wishes regarding terminal care and death will be discussed, and carried out. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 23 Vulnerable adults are protected through a range of policies and procedures and well-informed staff, which means that their human rights are protected. EVIDENCE: There are guidelines for staff about what to do if you suspect abuse, the responsibilities of the staff and the types and signs of abuse. There is a public disclosure policy dated Sept 2003. The homes policies regarding service users money and financial affairs ensure service users access to their money, valuables and safe storage is safe guarded. There is a gifts procedure that provides staff with guidelines about receiving personal gifts from service users. Staff are instructed during induction about physical and verbal aggression by a service user. Staff spoken to had a good awareness of Adult Protection issues. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not assessed during this inspection. EVIDENCE: Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 18 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): 34, 35 and 36. There are effective recruitment procedures in place to ensure service users are protected from harm. Service users benefit from a staff team who are appropriately trained to ensure that service users are cared for by skilled staff at all times. Service users benefit from having staff who are supervised and whose performance is appraised regularly. EVIDENCE: The inspector asked to look at the staff files for the most newly appointed staff members. There are three staff who have recently joined the staff team at Ceeley Road and all three have been appointed/transferred from another MacIntyre establishment. The files and all information pertaining to these staff members are still held at their previous place of employment. It is a requirement of the report that the home obtains evidence of recruitment checks undertaken for all staff members working within the home. The service manager telephoned to confirm that this would be carried out the same day. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 19 Staff meetings occur on a regular basis and minutes are kept of these. All care staff receive an annual appraisal and training needs are identified during staff supervision. Discussions with staff confirm that supervision is carried out on a monthly basis. There are no staff members under the age of eighteen and there are no staff under twenty one left in charge of the home at any time. All staff receive an induction programme relevant to the organisation. This covers equal opportunities training, disability equality training and race equality training. Further induction is carried out that includes fire safety, moving and handling techniques and core skills training. Progress is being made with NVQ training. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 20 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, 38 and 39 The manager is supported well by the staff team in providing clear leadership and demonstrating an awareness of their roles and responsibilities to the benefit of service users. Various methods of measuring quality assurance are in place ensuring that the quality standards that apply to service provision are maintained to a prescribed standard and, in relation to service users requirements, are not compromised. EVIDENCE: Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 21 The registered manager has been in post at Ceeley Road for approximately twelve months. Her experience has included work with older people and younger adults with learning disabilities. She will be undertaking her NVQ level 4 training shortly. Other training includes managing teams and meetings, budget management, epilepsy awareness, medication training and risk assessment training. Staff understand and can relate to the aims and purposes of the home. This is usually achieved through regular staff meetings, staff supervision and annual appraisals. There is a communications book, handover meetings, service user plans and training. The home has a complaints procedure in place and a whistle blowing policy, which enable staff and service users to voice concerns and affect the way in which the service is delivered. Macintyre Care has an equal opportunities policy in place and this was looked at during the inspection. The home has a service plan that is drawn up and agreed with the team. There is also a mission statement that all staff are aware of and this was evident through discussions held with staff. There is an Investor’s in Care report and a Portfolio of continuous improvement report. Both of these are updated annually. Internal audits include staff sickness, service users monies, staff training, accidents/incidents, service users teaching plans, NVQ monitoring forms are used, risk assessments and agency monitoring. The home has not undertaken any service user surveys during the last twelve months and it is recommended that the manager gives this serious consideration. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X x LIFESTYLES Standard No Score 11 X 12 3 13 X 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score x X X 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ceely Road (34) Score X 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X X x DS0000023048.V271791.R01.S.doc Version 5.0 Page 23 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 34 Regulation 17 Requirement The registered manager is required to ensure that evidence is available of all recruitment checks undertaken by the organisation for care staff working in the home. Timescale for action 30/12/05 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 39 Good Practice Recommendations It is recommended that an effective quality assurance system be implemented for service users who receive care and their representatives. Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Ceely Road (34) DS0000023048.V271791.R01.S.doc Version 5.0 Page 25 - 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. 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