Inspection on 24/01/06 for 36 Bramley Road

This inspection was carried out on 24th January 2006.

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

36 Bramley Road 06/01/09

36 Bramley Road 11/01/07

36 Bramley Road 19/09/05

36 Bramley Road 25/02/05

36 Bramley Road 28/10/04

36 Bramley Road 02/02/04

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Hillside

Applegarth

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Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 36 Bramley Road Market Deeping Peterborough PE6 8JG Lead Inspector Mr Toby Payne Unannounced Inspection 24th January 2006 2:45 36 Bramley Road DS0000002495.V279121.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 36 Bramley Road DS0000002495.V279121.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. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 36 Bramley Road Address Market Deeping Peterborough PE6 8JG 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) 01778 348125 www.sense.org.uk Sense East Mrs Nicola Elisabeth Wileman Care Home 4 Category(ies) of Sensory impairment (4) registration, with number of places 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Condition of Registration All four service users must have a learning disability and either a physical disability or a sensory impairment. 19th September 2005 Date of last inspection Brief Description of the Service: 36 Bramley Road is part of a group of homes in the area, managed by Sense. The home is a two storey house located in a residential area of the town of Market Deeping, not far from the town centre, which has a range of shops and local facilities The home is registered to provide personal care for up to 4 people with dual sensory impairments. All of the people live in single bedrooms. There is no stair or shaft lift installed. The property is domestic in design and in keeping with other houses in the road and has a small garden at the rear. The stated aims and objectives are to provide a safe and supportive environment, based on best care values for people who are deaf/blind, to promote a presence in the community through the use of local amenities and services and to build and maintain good relationships and a positive image. The home’s statement of purpose confirms that the minimum staffing ratio of the home is one staff member to 2 residents during the day and at night one wakeful member of staff and one who is sleeping in and on call. In view of the communication needs of people living in the home, the inspector relied on observations between staff and the residents, information provided by staff members and records as evidence as to whether standards were being met. It has been acknowledged by Sense that the home is no longer suitable for the current residents as a result of their changing needs. Efforts have been made to find suitable alternative accommodation where they all can live. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 2.45 p.m. It took place over 2½hours. The inspector spoke to two members of staff. In view of the communication needs of the 4 residents, the inspector relied on observations between staff and residents, information provided by staff members and records as evidence as to whether standards were being met. The main method of inspection was called “case tracking”. This involved selecting one resident and tracking the care they received through the checking of records, discussion with the care staff and observation of care records. What the service does well: What has improved since the last inspection? What they could do better: Where improvements are required, they are already being addressed by Sense, the manager or staff in the home. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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 and 5 Residents living at 36 Bramley Road receive clear information to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. EVIDENCE: No new person has been admitted since July 2002 and there is therefore an established community. The statement of purpose and service user’s guide for the home was reviewed on the 20/6/2006. The information was very clear and detailed and included Sense’s mission statement, including values and aims and objectives together with specific aims and objectives for 36 Bramley Road. This can be produced in large print, Braille, CD Rom, pictorial symbols and languages other than English. Each person had a contract/terms and conditions of residency. This is contained in Sense East terms and conditions. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 9 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, 8, 9 and 10 There is detailed care planning which includes risk assessments. The health and welfare of the residents is therefore fully met. People are encouraged to make decisions for themselves and be independent with the support and guidance of staff. EVIDENCE: Each resident had a detailed care plan. Care plans have been reviewed since the last inspection. Each person now has 2 care plans. The first includes their immediate needs with detailed and individual information about personal care, communication and where required risk assessments. The second relates to information, which is less immediate. This includes reviews and assessments. Care plans were very detailed and included details concerning their background/family, birthday, mobility, health and professional involvement, personal care, eating and drinking, speech, communication, social and emotional, making choice and specific needs. Each person also had information on how staff can relate to each person’s needs. The care plans have been developed wherever possible with the involvement of the resident, their family/advocate and other relevant people. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 10 There were also 6 monthly detailed reviews and risk assessments. These reviews included wherever possible the person and their family/advocate. Care plans were very individual, detailed and person focussed. There was evidence of reviews involving all associated in the resident’s needs. These included the resident, their family/advocate, representative of the home, representative of the Peterborough Resource Centre and their social worker. There are no formal resident’s’ meetings due to their sensory impairments. However staff ensure that people living in the home are involved in running the home wherever possible. Staff rely on their own observations of the residents and discuss at team meetings any changes thought necessary. Other professionals and relatives are invited to attend resident’s reviews and are given a monitoring report form to complete. There was evidence from the examination of a sample of care plans that they included very detailed risk assessments. Where required, assistance could be obtained from other professionals to formulate risk management strategies. The home also uses the advice/support of a behavioural therapist who visits the home every 6 months. The manager and staff have received training in order to manage challenging behaviours. There were also detailed policies and procedures. Sense have detailed policies and procedures concerning accessing personal records, confidentiality and data protection. During their induction staff are made aware of the importance of maintaining confidentiality. Records were seen to be kept securely. Residents have limited understanding of the written information about them but they all had personal log books which they take with them to the Peterborough Resource Centre and staff will also explain or ask the residents what they would like to be included in them. This was seen during the inspection. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 11 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): 11, 15, 16 and 17 Residents are involved in meaningful and appropriate activities, which include educational and recreational activities. EVIDENCE: 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 12 All people attend the Peterborough Resource Centre operated by Sense Monday to Friday between 09.30 and 16.00 hours. Activities at the Peterborough Resource Centre include horticulture, wood work, pottery, crafts, jewellery, information technology, literacy and numeracy, personal and social development and visits to Deaf/blind UK Peterborough. Each person had their own individual programme. Visitors are very welcome at any reasonable time. Arrangements can also be made for residents to visit their family and friends. Staff are available to give support where required. Other than their own bedrooms, there is nowhere else in the home people can see visitors in private. The home also regularly will phone relatives to give up to date information concerning the resident where because of distance it is difficult for them to visit. Bedrooms have been provided with door bells and flashing lights to enable the residents to have more privacy. All bedrooms have locks to enable privacy. Residents within their risk assessments are supported/guided in housework, which includes cooking, cleaning and laundry. Staff were seen to put principles of care into action by assisting the residents with their personal hygiene and ensuring that doors were closed and curtains drawn. When being admitted to the home details are obtained about the resident’ food preferences and likes and dislikes. There is a rotating 6 weekly menu. Two of the residents as part of their risk assessment cook with staff supervision. The other 2 within their capabilities assist with staff assistance/support. They also choose what they wish to eat but the nutritional content is monitored by the staff. At breakfast there is a choice including a hot meal. At lunch, when attending the resource centre there is a packed lunch and an evening meal provides a hot meal including a choice. Meals are taken in the dining area in the lounge on the ground floor. All staff are required to prepare meals and all have food hygiene training provided. The nutritional content of the menu is monitored. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 13 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 and 20 Resident’s health and emotional needs are met. Resident’s needs are monitored regularly. Staff give support and aid communication with people living in this home. EVIDENCE: The home operates a “designated social tutor” system in order to give a specific member of staff responsibilities for a particular service user. Care records clearly showed that any health or emotional needs were being met either by staff, specialist staff from Sense East or by the GP. Staff also showed knowledge of the particular needs of the residents. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 14 Each person receives an annual health check. Where required, residents are referred to their GP, Community Nurse, Continence Nurse, Dentist and Optician and Podiatry. Sense also have access to a behavioural therapist and physiotherapist. There are also 6 monthly audiology and dental checks. Where required, staff will accompany residents to these services. Sense have detailed policies and procedures concerning the receipt, storage, handling, administration and disposal of medication. The home received a pharmacy inspection on the 22/6/2005. The report raised no concerns and training was provided for staff. Up to date records are kept of the stock of medication. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 15 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 and 23 Any complaints received are taken seriously and residents are protected from abuse. EVIDENCE: Sense East have produced a “Resolving Issues” policy, which gives written and pictorial guidance concerning how a resident can raise any issues. This can be provided in Braille, tape or other languages other than English. No complaints have been received by the CSCI and the home since the last inspection. The home has an adult protection policy and all staff as part of their induction receives abuse training. They also receive yearly refresher training programme in the form of a questionnaire at their appraisal. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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, 25, 26, 27 and 29 People live in a safe, clean and well decorated comfortable home. EVIDENCE: Bedroom sizes range from 10.20 to 12.06 square metres. This meets the national minimum standards size requirements. However, not all bedrooms have a wash hand basin. This information has been included in both the statement of purpose and service user’s guide. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 17 One bedroom on the first floor does not have a wash hand basin. Sense have looked into providing a wash basin but on account of problems with drainage it has not been possible to provide this. One bedroom does not have a carpet but has laminate flooring provided. This on account of their individual needs and has been agreed with the resident, sponsoring authority and relatives. Two rooms have a loop facility installed. Bedrooms were individually furnished and decorated according to their needs and preferences. On the ground floor there is an en-suite bathroom, which includes a bath and shower. The shower room continues to be used as storage as it is not accessible for the service user. There is also an overhead hoist provided for ease of access to the bath. On the first floor there is one bathroom toilet and wash hand basin as well as a separate toilet and wash hand basin. There are thermostatic controls installed to bath and wash hand basins to regulate hot water temperatures. This to ensure that the temperature does not exceed 43º Centigrade. The water was last tested on the 21/6/2006 and records showed hot water temperatures were within safe limits. Toilet and bathrooms are lockable. Adaptations have been installed which includes an overhead hoist and bath aid, hand rails, stair rail, loop system, flashing light system to the front door. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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): 31, 32, 33 and 36 There are safe levels of staff and staff know how to meet the resident’s needs. EVIDENCE: The home is adequately staffed with employees who are experienced and competent to care for service users who have sensory impairments. Many staff were undertaking qualifications in care. There was a very detailed and person centred programme of education to equip staff with the many skills required to meet the resident’s needs. Staff spoke of the support they received and of the supervision and appraisal systems in place. All care staff are responsible for care, catering, domestic and laundry duties. They are therefore responsible for all the services in the home. There are no separate domestic and catering staff. Care staff support the residents to be as independent as possible with these tasks. All staff receive a comprehensive induction and education programme covering all aspects of caring for people who have sensory disabilities. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 19 At night there is one wakeful and one sleep in member of staff who is available if required. Staff members spoke of the support they received and of working as a team. Formal supervision is also provided on a regular basis. An appraisal system is also provided. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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, 39, 41, 42 and 43 Staff are lead by an experienced, competent and committed manager who supports the staff and residents. EVIDENCE: The manager was registered by the CSCI in June 2005 but joined Sense East in 1993. She has extensive care and management experience. She has qualifications in law, psychology, teaching as well as wide practical knowledge in deaf blind and sensory awareness. She is working towards a management qualification. Monthly meetings are held with staff. The last minutes were available for the 14/12/2005. Staff felt they were valued and supported. There are detailed policies and procedures, which enable staff to deliver care and support. Staff were seen to attend to residents in a confident, knowledgeable, and sensitive manner. They clearly knew the needs of each person and demonstrated excellent communication skills. A relaxed atmosphere pervaded the home. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 21 Sense have quality and monitoring systems in place and a comprehensive and detailed quality audit. This has included a questionnaire to purchasers, staff and the resident’s families. The audit has resulted in an action plan. The home also receives monthly unannounced visits by the Sense area manager and detailed reports of these visits are sent to the Commission. There were no concerns. Sense have achieved the Investors in People award as a result of its commitment to staff education and development. Records examined on the day of the inspection were available, detailed, and up to date. There was evidence to show they had been reviewed regularly. Records examined included care records, accident records, equipment test records, fire system tests and hot water temperatures. Sense have comprehensive health and safety policies, which also include risk assessments. The last fire risk assessment was on the 11/1/2006. Doorgards have been installed to the living room, kitchen and one person’s bedroom door. This enables these doors to be left open but in the case of fire the doors will automatically close. Sense also undertook a detailed health and safety audit on the 19/1/2006. There were no concerns raised. Records were available to indicate that risk assessments had been undertaken. 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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 3 2 x 3 x 4 x 5 3 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 3 26 3 27 3 28 x 29 3 30 x STAFFING Standard No Score 31 3 32 3 33 3 34 x 35 x 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 x 3 3 3 LIFESTYLES Standard No Score 11 4 12 x 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x 4 4 3 x 3 3 3 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 36 Bramley Road DS0000002495.V279121.R01.S.doc Version 5.1 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!