Inspection on 01/07/05 for 34 Elsee Road

This inspection was carried out on 1st July 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

34 Elsee Road 13/11/09

34 Elsee Road 20/09/07

34 Elsee Road 15/06/06

34 Elsee Road 17/11/05

34 Elsee Road 22/03/05

34 Elsee Road 16/11/04

34 Elsee Road 21/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 34 Elsee Road 34 Elsee Road Rugby Warwickshire CV21 3BA Lead Inspector Justine Poulton Unannounced 01 July 2005 09:00 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. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 34 Elsee Road Address 34 Elsee Road Rugby Warwickshire CV21 3BA 01788 547781 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) RMH Homes PC 6 Category(ies) of LD 6 registration, with number of places 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 March 2005 Brief Description of the Service: Elsee Road is a large terraced Victorian house providing a permanent home for five people with learning disabilities and respite stays for one person. The home is near the centre of town. There is no parking at the home, and the road has double yellow lines, and residents permit parking only. Care staff support residents at all times when they are at home. Residents are not routinely at the home during the day, though some residents will arrange to be at home occasionally. The house is one of four services operated by Rugby Mencap Hostels, a parent-led service that provides residential care for people in Rugby. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday and was carried out from 9:45am until 14:50pm. The organisations manager, residents and staff co-operated fully with the inspection. A total of 22 standards were inspected on this occasion of which 14 had shortfalls. A number of requirements have also been carried forward from the previous report for this home, as they were either not met or not inspected on this occasion. One of the residents was at home for all or part of the day and was spoken with informally. Staff on duty in the morning left shortly after the inspector arrived. The remaining member of staff was from another service, and was providing day care support for the resident staying at home, therefore no staff members were spoken with on this occasion. In addition to this, records, files and policies and procedures were also inspected. Information pertaining to respite users of the service was not inspected on this occasion. The home has recently undergone a change of manager, with the new manager only being in post for a short time. At the time of writing this report an application for the managers registration with the Commission for Social Care Inspection had been received. The inspector would like to thank the organisations assistant manager, the homes manager and the resident for their co-operation and hospitality during the inspection. What the service does well: The service provides a homely environment for the residents, that is clean and comfortable. The atmosphere during the inspection was relaxed, with the resident that was at home for the day appearing comfortable in his surroundings. Information about the home is in place for prospective permanent residents and those that would be staying for respite. Preadmission assessment and care planning documentation is sought for prospective permanent residents in order for the home to be able to ascertain whether it is able to meet needs. Residents are supported to attend a variety of placements and activities that are age, peer and culturally appropriate. All residents have given their consent to medication. Information to confirm that 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 6 residents are able to complain was available. Information contained within the staff files examined confirmed that recruitment procedures for new staff appointed to the home are safe, with references and Criminal Records Bureau checks having been carried out as required. What has improved since the last inspection? What they could do better: The format of care planning and risk assessment information needs improving in order to make it easily accessible and more professional. Within this, evidence to confirm that residents have been involved in the compiling of and agreement of their care plans must be in place. Although residents are able to arrange to have days off from their placements during the week, systems to ensure that they can choose to do this on an unplanned basis would be of benefit. Generally, residents are offered routine healthcare appointments, however evidence to confirm that this is the case for all residents was not available, and must be in place within their care plans. Staff supervision has not been carried out in line with National Minimum Standards. Although dates for supervision sessions with staff are now planned, the manager must ensure that they take place on a regular basis. Fire safety is impinged within the home with fire doors being propped open by wedges. The financial viability of the home remains a query as the organisation has not yet provided the information requested. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 7 All requirements that have been carried forwards from the last inspection as either ‘Not Inspected on this occasion’ or ‘Not Met’ must be addressed by the next inspection of this home as a matter of urgency. 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. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 8 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 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 9 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, 2 and 5 Prospective residents are provided with accurate, comprehensive information about the home. Pre admission assessment and care planning documentation enables the home to determine whether it can meet prospective residents needs. Minor amendments to residents’ contracts will further safeguard residents placements in the home. EVIDENCE: The home has a Statement of Purpose and Service User Guide in place. One resident moved into the home on a permanent basis in September of last year. Examination of his file confirmed that the required Community Care Assessment and care planning documentation was in place. Three residents files were examined during this inspection. All three had contracts in place between themselves and Rugby Mencap Homes. Minor amendment to these will ensure that they fully meet standard 5 of the National Minimum Standards. Documentation for respite guests that stay at the home was not inspected on this occasion. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 standard(s) 6 and 9 Current care planning documentation does not ensure that residents know that their assessed and changing needs are met. Current risk assessments in place do not ensure that staff have accurate up to date information to effectively safeguard residents. EVIDENCE: All of the residents in the home have care plans in place. Three of these were examined during this inspection. Information concerning the residents care and support needs was detailed and dated. Review dates were also included. In one file the resident and staff member that completed the form had also signed it. A lot of the information within the care plans was hand written and scrappy; with the files themselves being in need of updating. In some instances information required by law was also missing, such as admission dates. The assistant manager for the organisation advised that work was in progress to provide care plans for residents in a much more professional way. A blank copy of the format for care planning that is to be used was subsequently sent to the inspector after the inspection. Some risk assessment information was in place, but the style and paper work for these was poor, with little or no information on minimising or preventing risk, no dates, signatures 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 11 or review dates. Again it was advised that these are to be updated as part of the work being undertaken on the care plans. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 standard(s) 12 Residents lead a varied lifestyle, participating in culturally, age and peer appropriate activities. The option to choose to take an unplanned day off from their daytime activities restricts residents rights to spend their time as they wish. EVIDENCE: Four out of the five residents were out during the inspection, with one remaining at home for the day. Residents attend a variety of placements during the day which include work placements at places such as Tesco and Ryton Gardens, local college courses, day centres or the Community Placement Unit. The resident that was at home for the day was being supported by a member of staff from another Rugby Mencap Home, and went out for lunch during the inspection. The impression given was that this was a usual way for him to spend his day, however it was contradictory to the information within his care plan that listed day activities for five and a half days per week. At the present time there is no provision for residents to take an unplanned day off from their day time activities should they choose. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 13 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 standard(s) 18, 19, 20 and 21 Residents’ personal care needs are identified. Lack of signatures on care plan documentation does not confirm that residents have agreed their care and support needs. Most residents’ healthcare needs are identified and monitored with routine and specialist appointments being arranged as necessary. Residents have signed medication consent forms. EVIDENCE: Information was available within the residents care plans that provided details of how best to provide support or personal care. These were both dated and included review dates. Only one plan looked at however was signed by the resident and staff member that had written it. Details of routine medical appointments such as dental or optical appointments were available within two of the files looked at. The last recorded date for a dental appointment for one resident however was 7th August 2003. The father of one resident assists in making routine healthcare appointments. The home has no record of when these have been attended within the care plans to confirm that they are offered at the recommended intervals. Residents have signed a consent to medication form which is in their file. Evidence that medication reviews take place was also available. No other areas of medication were looked at on this occasion. There was no evidence within any of the residents files looked at to 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 15 confirm that residents wishes regarding aging, illness and death have been discussed. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 standard(s) 22 Residents views are listened to and acted upon in line with organisational policy. EVIDENCE: Work has commenced on compiling policies and procedures in line with appendix 3 of the National Minimum Standards. The manager stated that the managers of the organisation are undertaking this work. A complaints policy and a vulnerable adults policy are amongst those that have been completed to date. The resident that was at home for the day told the inspector what he would do and who he would talk to if he was unhappy about anything in the home, and felt happy that he would be listened to should he need to make a complaint. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 standard(s) 24, 25 and 28 The environment is comfortable and homely. Residents bedrooms are pleasant, and generally suit their needs. Space is available for all residents to share should they wish. EVIDENCE: The home is a three storey Victorian terraced house in a residential street close to Rugby town centre. The second floor has two bedrooms and a bathroom with toilet. It was light and airy on the day of the inspection as velux windows in the roof allow ample natural light in to the home. The first floor has three bedrooms, a bathroom with toilet and a separate toilet. This landing was decorated in dark wallpaper, with very little natural light. The staff bedroom is also on this floor. The ground floor has a dining room, lounge and second reception room, which is currently being used as the staff office, although residents still have access to it. There is also a modern kitchen with domestic appliances, a laundry area and a toilet. The environment was homely and pleasant, clean and tidy with no unpleasant smells. One resident showed the inspector his bedroom, which he said he liked, but being on the second floor was “murder”. The lounge and the dining room are shared by the residents, and both were very pleasant rooms. Evidence was available within residents meeting minutes of discussions being held about what colour to decorate the 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 18 dining room. The use of the second reception room as the office for the home impinges on a quiet space that could be enjoyed by the residents as an alternative to the lounge if they wanted to read or listen to music. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 19 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) 34 and 36 New Staff have been recruited to work in the home in line with current good practice that safeguards residents. The lack of staff supervision however leaves residents vulnerable to potential risk to their health and well-being. EVIDENCE: Evidence was available within the staff files looked at to demonstrate that the home has satisfactory recruitment practices for new staff. An application form, terms and conditions of employment, a criminal records bureau check and photocopies of documents that confirm identification were available. One also had two written references. Another file looked at did not include any references, however this was a long standing member of staff who had been employed some considerable time ago. Staff supervision records were in place, however it was clear that staff had not received supervision in line with National Minimum Standards since February 2005. Staff supervision contracts were also in place. Dates for supervision were scheduled for all staff in July and August, and the manager said that supervision would be carried out in line with standards from now on. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 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) 37, 42 and 43 It was too soon at this inspection to determine whether service users will benefit from a well run home, as the manager is new in post. The use of door wedges with fire doors places residents at risk of harm. EVIDENCE: The home has a new manager in post, who is currently going through the process of becoming registered with the Commission for Social Care Inspection. It was too soon at this inspection to determine whether the manager will have a positive impact on the running of the home. The Health and Safety within the home was not inspected fully on this occasion, however it was noted that some fire doors were propped open with decorative door wedges. A certificate of gas boiler safety was requested at the previous inspection. This has not yet been received by the Commission. The manager said that a fire risk assessment has been completed, but is located at another of the organisations homes. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 21 A business plan for the home for 2005/6, audited accounts for 2003/4 and the projected income and expenditure for the home for 2005/6 have not been received by the Commission as required at the last two inspections. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 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 2 x x 2 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x 3 x x Standard No 11 12 13 14 15 16 17 x 2 x x x x x Standard No 31 32 33 34 35 36 Score x 2 x 3 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 34 Elsee Road Score 2 2 3 2 Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 2 E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 23 YES 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 2 Regulation 14, 15 Requirement Ensure that full assessments have been done for all residents coming in for respite stays. Compile service user plans based on these assessments. (01/06/05, Not inspected on this occasion.) The addition of bedrooms occupied by residents is required in their contracts. Maintain up to date and accurate care plans for all residents and review these. (15/05/05, old timescale not met.) Systems for monitoring the quality, quantity and review of written assessments and individual plans about the needs of people living in theb home must be put in place.( 15/05/05, old timescale not met.) Risk assessments must be reviewed and more comprehensive information included. They must be dated, signed and have review dates included. Consideration must be given about how to support residents should they choose to have an unplanned day off from their Timescale for action 30/09/05 2. 3. 5 6 5 15 31/08/05 31/08/05 4. 6 15 31/08/05 5. 9 13(4) 31/08/05 6. 12 12(1)(b) 30/09/05 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 24 placements during the week. 7. 8. 18 18 15(2) 18 Evidence to confirm that residents have agreed their care plans must be in place. The registered person must ensure that guiding principles for housework and kitchen use with residents are developed and provided for staff. (01/06/05, Not inspected on this occasison.) Evidence to confirm that all residents are offered routine healthcare appointments at the required intervals must be in place. The registered person must ensure that service users and with consent, their families are consulted about terminal care and arrangements on death and that their wishes are recorded in the plan of care.( old timescales of 01/04/05 and 15/05/05 Not met) Records of staff training that can evidence the competence and skills of staff and the organisations training and development plan must be maintained.(15/05/05, not inspected on this occasion.) A staff training and development plan must be put in place to to ensure that staff receive the training they need to do the job and meet the identified needs of the residents. ( 15/05/05, Not inspected on this occasion.) Staff must receive formal recorded supervision a miminum of six times per year. The registered person must make regular reviews of the quality 0f the service based on its Statement of Purpose, aims and objectives, and based on resident consultation. (15/05/05, 31/08/05 31/08/05 9. 19 13(1)(b) 31/08/05 10. 21 12 31/08/05 11. 32 18 30/09/05 12. 35 18 30/09/05 13. 14. 36 39 18(2) 24 30/09/05 30/09/05 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 25 Not inspected on this occasion.) 15. 42 23(4)(a)(c Door wedges must be removed )(i) from fire doors, and an approved system of holding fire doors open be installed. 13(4)(a)(c The registered person must ) ensure that a certificate of gas boiler safety is sent to the commission. (15/05/05. Not met) 23(4 The registered person must )(a) ensure that a fire risk assessment is available in the home. 25 The registered person must ensure that copies of the business plan for Elsee Road 2005/6, the audited accounts for Elsee Road for 2003/4 and projected income and expenditure for Elsee Road for 2005/6 are submitted to the Commission. ( Old timescales of 01/05/05 and 15/05/05 Not Met) 30/09/05 16. 42 08/08/05 17. 42 08/08/05 18. 43 08/08/05 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. 2. Refer to Standard 24 24 Good Practice Recommendations Consideration should be given to ways of ensuring that the landing on the first floor of the home is made lighter. Consideration should be given to providing office space in the home, separate for residents living space. 34 Elsee Road E53 S4287 34 Elsee Road V236424 010705 stage 4.doc Version 1.40 Page 26 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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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