Inspection on 22/11/06 for 35 Valley Road

This inspection was carried out on 22nd November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

35 Valley Road 12/09/07

35 Valley Road 04/05/06

35 Valley Road 15/12/05

35 Valley Road 23/11/04

35 Valley Road 21/05/04

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 35 Valley Road Clevedon North Somerset BS21 6AQ Lead Inspector Paul Grey Unannounced Inspection 22 November 2006 10:30 nd 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 35 Valley Road Address Clevedon North Somerset BS21 6AQ 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 879634 0117 9699000 www.brandontrust.org The Brandon Trust Mrs Linda Purnell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 4 persons aged between 18-64 years. Date of last inspection 4th May 2006 Brief Description of the Service: Valley Road is a small residential property located on the outskirts of Clevedon. The service has access to local bus routes and is within walking distance of local shops. The home cares for up to 4 adults with learning disabilities between the ages of 18 and 64 years of age. The service is owned and staffed by the Brandon Trust. The home charges in the region of £917.39 a week. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over a two separate days in the presence of the acting manager. During this process the inspector met the residents of the home, spent some time observing them and spoke with the staff team. The inspector also conducted a tour of the premises and reviewed the care files and documentation at the home. At the time of inspection there was no registered manager at Valley Road. The Brandon Trust has appointed an acting manager. The service is in the process of recruiting a new Registered Manager. During the inspection process the inspector found a well run service, happy service user group and settled staff team. The inspector made no requirements and notes a robust service that appears well managed. 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. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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 the following standard(s): 2 Quality in this outcome area is good. The service understands the importance of providing sufficient information to service users are choosing a Care Home. It has innovative ways of helping prospective individuals choose a home that will meet their needs and preferences. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector reviewed 2 care files. One was for the most recently admitted service user. The inspector met with two service users, spent time observing them and talking with the manager. Care files contained a sensitive and in depth assessment of service user’s needs. This included a diet plan and a detailed assessment of the service user’s ability to communicate. The staff team had supported a series of visits to the home culminating in an overnight stay prior to moving in for a trial period. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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 the following standard(s): 6, 7, 9 Quality in this outcome area is good. The service user plan is developed in partnership with the service user and is based on an efficient assessment. The care plan is used as a working tool and is understood by the individual and all staff. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Inspector reviewed the service users plans of care, observed service users and spoke with the manager. Valley Road uses the Brandon Trusts person centred planning document called planning for life. The information in this document describes how the assessed needs of the service user will be met. The service user plans demonstrated regular reviews of care needs and re assessment where indicated. Service users are involved with their own care planning as much as possible. Plans of care did contain restrictions on choice and movement, for example, service users are unable to leave home without an escort. However, these restrictions were always reasonable and based on an assessment of the service users needs and abilities. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 9 Care files are written from the service user’s prospective. This enables the staff team to understand their preferences and rights. The staff team support also support them to make their own decisions based on service user feedback and care planning. The manager was able to demonstrate how the service supported independence and decision-making by the client group. All care files audited contained comprehensive risk assessments. Risk assessments were based on the service user’s individual plan of care and demonstrated strategies to minimise levels of risk experienced by the service user group. The Inspector found nothing unduly restrictive in the risk assessments. Risk assessments had been regularly reviewed. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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): 13, 15, 16, 17 Quality in this outcome area is Excellent. Residents are able to enjoy a full and stimulating lifestyle with a variety of options to choose from. The home has sought the views of the residents and considered their varied interests when planning the routines of daily living and arranging activities both in the home and the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Valley Road maintains close ties with the local community. Service users are supported to access the local community for a wide range of activities. Due to the extent of their disability, service users require and escort into the community to access local shops, clubs. The inspector noted evidence from the manager, staff duty rota and care files that service users are supported with regular access to the community and day care activities at Scotch Horn Leisure centre. Evidence from staff, the manager and care documentation demonstrate that 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 11 the home will support service users to maintain relationships inside and outside of the home. Friends and family are welcomed into the home and service users are encouraged to maintain contact with those around them. None of the service users at the home are involved in an intimate relationship. Valley Road has a relaxed and flexible routine. Service users are supported to get up at their preferred time, unless they have day care activities. On these days service users are supported to be up and ready by the staff team. At the time of inspection 2 service users were about to go to day care, (9.30 a.m) and 2 had just got up. The manager outlined how one service user woke as early as 5 a.m on some days. The daily notes showed that the staff team would encourage the service user back to bed till 6 a.m but would support them if they choose not to sleep. Throughout the inspection service users were treated with dignity and addressed by their preferred name. The home has a 4 weekly rotating menu. Service users are involved in choosing the menu via pictures of different meals and foods. The menu was varied and could be changed if service users preferred an alternative. The manager said that the home could cope with a wide range of dietary needs and could alter its menu to meet cultural or religious needs should it be needed. The inspector observed two service users eating a relaxed and unhurried meal during inspection. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 12 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, 19, 20 Quality in this outcome area is good. Staff understand the key principles of giving personal support and are responsive to the varied and individual requirements of the residents. Service users benefit from a comprehensive assessment of their health and wellbeing. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The inspector reviewed personal support planning, spoke with staff and observed service users. Documentation outlined service users preferences with their personal care. Staff were able to outline these preferences and explain how they cared for the individual concerned. The inspector observed staff supporting a service user during the inspection. The service user was treated with dignity and taken into another area of the home to address a personal care issue in privacy. The staff team support service users to choose their own clothing and appearance. All service users have designated key workers/ carers. Care files sampled contained detailed information regarding the health care needs of service users. The manager outlined the role of the team monitoring the health of service users. The inspector found evidence of health monitoring 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 13 by the team, and the involvement of the GP for one service user. The manager said that the staff team support service users to attend any appointments for health monitoring. No service users at the home are able to administer their own medication. The team administer medication where necessary and document this in the medication records. Medicines are securely stored and administered by appropriately trained staff. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 14 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, 23 Quality in this outcome area is good. The service has a complaints procedure that is up to date, very clearly written. It can be made available on request in a number of formats and has a hand out available for the service user group. The service has a complaints procedure that is up to date, very clearly written, and is easy to understand. It can be made available on request in a number of formats This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are protected by the complaints procedure and culture at the home. The staff team support service users to express when they are unhappy or dislike something. One staff member told the inspector that service users may not be able to express themselves verbally but left little doubt if they were unhappy about something. The team have received training and supervision to help them identify when the service user is unhappy. The inspector found policies and procedures relating to the service user’s rights and ability to complain. The home has a complaints leaflet featuring widgets (pictures) of unhappy faces. This handout explains who to speak to if the service user is unhappy about something. The home has had no complaints at the time of inspection. Staff at the home are screened to ensure that unsuitable applicants do not work at the home. These records are stored centrally at Brandon Trust HQ. These were reviewed by the inspector in July 2006 and complied with National Minimum Standards. The Trust provides training to staff in order that they can understand the causes of violence or aggression and appropriately manage the 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 15 situation. There have been no incidents at the home since the previous inspection. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 16 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, 30 Quality in this outcome area is Excellent. The provider and manager have ensured that the physical environment of the home provides for the individual requirements of the residents who live there. The living environment is appropriate for the particular lifestyle and needs of the residents and is homely, clean, safe and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Valley Road is a pleasant terraced house providing a comfortable homely environment for service users. The premises are accessible to able-bodied service users with pleasant furnishings and fixtures of good quality. Services users benefit from a modern, comfortable home. The premises were clean and hygienic throughout. The home has no offensive odours and infection control policies and procedures are in place. The Inspector noted hand-washing facilities sited in the kitchen, and a small utility room/laundry to clean service users clothing and bedding. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 17 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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): 32, 34, 35 Quality in this outcome area is good. Residents have confidence in staff who care for them. Rotas show well thought out and creative ways of making sure that the home is staffed efficiently, with particular attention given to busy times of the day and changing needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The acting manager was able to demonstrate that staff have regular training to enhance their care skills. Recent training included identifying abuse, communication skills for staff and managing aggressive behaviour. The inspector observed staff interacting with service users during the inspection. Staff demonstrated good listening and communication skills. Service users appeared to be comfortable approaching staff who did not exclude them from the inspection process. The inspector reviewed staff records. The home had evidence that appropriate staff records were stored at the Brandon Trust HQ. Records included 2 references, 2 forms of identification, police check and Protection of Vulnerable Adults check. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 19 The inspector reviewed staff training and induction. The home has a structured induction package for all new staff. Records sampled showed new staff were orientated around the basic principles of care and safe working. Staff had signed to confirm they had worked through each stage of the induction. A staff member spoken with could confirm she had paid leave to train and was supported to attend training events run by the Trust. Training is funded by the Brandon Trust so the home does not have a dedicated training budget. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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, 39, 42 Quality in this outcome area is adequate. The acting manager is qualified to run the Home; they are aware of and work to the basic processes set out in the National Minimum Standards. The service has sound policies and procedures, which the manager effectively reviews and updates, in line with current thinking and practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: At the time of inspection the home did not have a registered manager. An acting manager is running the home and the full time post will shortly be advertised in accordance with Equal Opportunities legislation. The acting manager is a registered nurse with in excess of the 2 years supervisory experience required. The acting manager has ensured the staff team undertake regular training and updates. Service users are supported by an efficient well managed team. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 21 The acting manager has completed the Brandon Trust quality review package. This was conducted in accordance with it’s annual ‘quality assurance’ objectives. The acting manager attempted to obtain views from the service user group using evidence from care files and observations on the service users behaviour. Information was also sought from professionals outside of the service. The information obtained was used by the manager to review care offered to service users. The inspector reviewed health and safety practices at the home to ensure the service users are protected. The manager was able to provide documentary evidence of regular fire, manual handling and first aid. Whilst touring the premises the inspector noted no obvious health and safety hazards. Regular fire equipment maintenance had been documented and fire drills had been conducted. 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 x 26 x 27 x 28 x 29 x 30 4 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 4 14 x 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 35 Valley Road DS0000008088.V304491.R01.S.doc Version 5.2 Page 24 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. 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