Inspection on 04/05/06 for 35 Valley Road

This inspection was carried out on 4th May 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

35 Valley Road 12/09/07

35 Valley Road 22/11/06

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 4th May 2006 09:30 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 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.V293360.R01.S.doc Version 5.1 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.V293360.R01.S.doc Version 5.1 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 The Brandon Trust Mrs Linda Purnell Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 4 persons aged between 18-64 years. Date of last inspection 15th December 2005 Brief Description of the Service: Valley Road provides accommodation for up to 4 service users with learning disabilities. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was conducted in the presence of Patricia Cox, the senior care assistant at the home. Previously, the home has performed well. However recent changes in the needs of one service user, high staff turnover and lack of full-time manager had caused a general deterioration in the service. The Inspector found the new staff team settling in, content service users, and a generally pleasant environment at the home. The homes administration and documentation continues to meet national minimum standards. The Inspector commends the new staff team and the supporting manager, Amanda Reading on their efforts to maintain and stabilise the home. The Inspector reviewed key standards at the home, in addition to a range of standards addressing general management. The homes need for a full-time manager has impacted on its performance during this inspection. The Inspector would observe that the services shortfalls would be easily addressed by the presence of a full-time manager. 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.V293360.R01.S.doc Version 5.1 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.V293360.R01.S.doc Version 5.1 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, 3 The outcome for service users in this area is good. Prospective service users have an up-to-date statement of purpose which includes a summary of the purpose of the home to enable them to make an informed choice about where to live. Potential service users needs are assessed and care planned by the home. EVIDENCE: There have been no recent admissions to the service. The service user group was admitted when the home opened. The Inspector audited service user files and found that an ongoing process of assessment is in place. Assessment processes continue to meet national minimum standards. The Inspector could not find sufficient evidence to conclude that the service exceeds the National Minimum Standards regarding this standard. The Inspector noted the home provides a reasonable standard of documentation. The Inspector noted that service users specialist needs a clearly documented. Specialist input regarding learning disabilities were clearly documented and the home was able to evidence good practice. Due to extensive changes in the staff team the Inspector was unable to draw a meaningful conclusion regarding the collective abilities and skills of the team. The senior carer outlined the assessment process that the home would go through with a potential service user. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 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 The outcome for service users in this area was good. The service users changing needs are reflected in their individual care plans. Service users are assisted to make decisions about their daily lives if needed. Service users are supported to take reasonable risks as part of everyday life. Due to the staff and management changes these risks were not always reevaluated after a reasonable period of time. EVIDENCE: The Inspector noted the home retains its person centered plans. These documents were comprehensive, in depth and written from the service users point of view. The Inspector noted care plans were appropriate to the needs of the service users. The Inspector noted care plans had been reviewed and were reasonably maintained. The Inspector noted evidence from staff statement, and service user documentation that the staff team support service users to make informed 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 9 decisions to the best of their ability. No service users manage their own finances at the home, this process is supported by staff. The Inspector reviewed the homes risk assessments. The home had comprehensive and in-depth risk assessments covering every conceivable eventuality. The Inspector noted clear evidence on the part of the team to minimise identified risks where possible. The Inspector spoke with the senior carer, Patricia Cox regarding regular reviews of risk assessments. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 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): 12, 13, 15, 17 The outcome for service users was good. Service users are supported by the home to take part in leisure activities both inside and outside of the home. Service users are supported by staff to participate in the local community. Service users are supported by staff at the home to maintain family links and friendships. Service users receive a pleasant and healthy diet with a varied menu. EVIDENCE: Service users at Valley Road do not take part in employed activity. However, staff support the service users engage in a range of educational and stimulating activities inside and outside of the home. The Inspector has noted evidence from the for staff team and documentation that the homes staff support service users to be positively included in the community. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 11 The Inspector noted evidence from staff statement and service user care plans that the staff team will support service users to maintain relationships both inside of the home and outside of it. Friends and family will be welcomed into the home and service users are encouraged to maintain contact with those around them. The staff team will support service users to do this. None of the service users at the home are involved in an intimate relationship. During inspection the Inspector noted that service users were offered a pleasant and varied menu. The service users next meal was indicated on the refrigerator in the kitchen. Staff inform the Inspector the service users are involved with choosing their own food plus food that could be available for treats, such as take-away is. The Inspector also noted evidence of a pleasant and varied menu. Service users can choose whether to eat with the other service users, or to eat alone. The staff inform the Inspector that service users are encouraged to eat together, or with staff to maintain a community feel to the home. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 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 The outcome for service users was good. Service users receive personal support in a manner they would prefer. Service users are supported to meet their physical and emotional needs by the home. Service users are supported and kept safe by the homes policies and procedures dealing with medication. EVIDENCE: The Inspector gathered evidence from documentation and staff statement evidence. The Brandon trusts person centered planning documents were particularly useful for this. The Inspector found supporting evidence that staff provided service users with flexible and caring personal support. Writing in the person centered planning indicated that staff treated service users with dignity and respected their privacy at all times. Personal support if it is needed is provided in private with due regard for the service users dignity and preferences. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 13 The Inspector found evidence that the service supports service users to meet their own physical and emotional health needs. All service users were registered with the GP. The Inspector noted that the staff team monitored service users health and supported service users to obtain specialist help where needed. Service users, given the degree of their learning disability, are unable to dispense and retain their own medication safely. The homes policies, procedures and staff training protect the service users at all times. Medication charts were clear, up-to-date with no crossings out or omissions. Medication records contained details of medication to be given, the reasons medication was to be given, and potential side-effects of any medication. Records were comprehensive and up-to-date. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 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 The outcome for service users was good. Service users are supported to a their views by staff at the home. Service users are protected from abuse or neglect by staff at the home. EVIDENCE: The Inspector noted evidence of a clear and accessible complaints procedure. The Inspector spoke with the senior carer, Patricia Cox, regarding potential complaints and how they were dealt with by the team. Service users would have difficulty making a formal complaint because of their learning disabilities. However service users can and do voice their own wishes or displeasure at situations. Staff are able to understand this and will react accordingly. The staff were able to give examples of such incidents. The Brandon trust provide employees with training to detect and report suspected abuse. Any allegations of abuse would be recorded at the home. The staff spoken with were clear about their actions in the event of suspected abuse. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 15 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 The outcome for service users was good. Service users and live in a homely comfortable and pleasant environment. Service users live in a clean, pleasant and hygienic environment. EVIDENCE: Valley Road is a pleasant terraced house providing pleasant homely accommodation for the service users. The premises are thoroughly accessible to able-bodied service users with pleasant furnishings and fixtures of good quality. The premises were clean and hygienic throughout. The Inspector noted no offensive odours. 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.V293360.R01.S.doc Version 5.1 Page 16 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): 31, 32, 33, 36 The outcome was poor. Service users may experience a degree of ambiguity regarding staff roles and responsibilities in the absence of the supporting manager. Service users are supported by a competent and qualified staff. However this is impacted by the lack of a full-time manager. Service users are supported by a generally effective staff team. However, this is also adversely effected by the absence of a full-time manager. Staff supervision was adversely impacted by the absence of a full-time manager. The current senior care assistant and supporting manager are striving to address this. EVIDENCE: The Inspector checked staff job descriptions. The Brandon trust supplies clear and comprehensive job descriptions for staff team members. The Inspector noted that the senior carers job descriptions did not entirely reflect the responsibilities placed on the individual during the absence of a full-time manager. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 17 The senior carer is required to meet any management shortfalls during the period when no management support is available. With a management presence of only 40 fulltime managers hours this is a significant issue for employees and the organisation. The Inspector audited staff supervision. The Inspector noted that there had been insufficient staff supervision during the absence of the manager. This is in no small part due to large staff turnover in addition to lack of appointed manager. The Inspector notes that considerable efforts have been put in by the staff team to address this. The Inspector recognised that this has recently been addressed and that the senior carer and supporting manager have now addressed staff supervision. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 18 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, 42 The outcome for service users was poor. Service users have been impacted by the loss of the existing staff team and absence of a full-time manager. The Inspector notes staff turnover is approaching 100 . Whilst the Inspector recognises the home maintains a positive and inclusive atmosphere, the absence of a full-time manager impacts considerably on the service. Service users health and safety are protected in the home. EVIDENCE: The home currently does not have an active manager. The previous manager is on long-term sick. Management support is provided by Amanda Reading, the manager of the rambles, for 2 days a week. The senior carer is acting up to cover management shortfalls the remaining 3 days a week. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 19 This does present a number of issues for the trust. Namely accountability for the home during the absence of the supporting manager Amanda Reading. The Inspector spent some time reviewing the management ethos of the home. In the absence of a manager this is a somewhat difficult task. Documentation and staff statement evidence from Patricia Cox would seem to indicate that the home offers a positive, open and inclusive atmosphere. During inspection the service users were involved with activities in the home, met the Inspector, and came into the office whilst the Inspector reviewed documentation. These activities led the Inspector to believe that service users were involved in all aspects of the home generally. However, in the absence of a full-time manager the Inspector was unable to find sufficient evidence to indicate that the home meets national minimum standards. Staff at the home continue to receive appropriate health and safety training from the Brandon trust. Staff have moving and handling training, fire training was up-to-date. 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 20 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 3 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 2 32 3 33 2 34 x 35 x 36 3 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 3 13 3 14 x 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 1 2 X X X 3 X 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 21 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 OP37 Regulation 18 (2) Requirement The Inspector requires the Brandon trust forward a clear outline regarding who has managerial responsibility of 37 Valley Rd. Specifically who is holds accountable in the absence of the supporting manager, Amanda Reading. The inspector requires Brandon Trust clarify the management role, (if any) of the senior carer. Specifically in the absence of Amanda Reading Timescale for action 01/06/06 2 OP31 18 (2) 18 (1)a 01/06/06 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.V293360.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 35 Valley Road DS0000008088.V293360.R01.S.doc Version 5.1 Page 23 - 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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