Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 24/05/06 for 4 Maer Lane

Also see our care home review for 4 Maer Lane for more information

This inspection was carried out on 24th May 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Now that a number of issues raised at the last inspection have been addressed it can be seen that the service users are looked after by a well trained and dedicated staff team. This, combined with the building being homely, makes it a pleasant place for the service users to live.

What has improved since the last inspection?

It was clear that a great deal of effort has been made in all of the areas that were found to require attention at the last inspection. Staff training is one of the areas that has benefited from this attention and now it is clear that staff are receiving the training appropriate to their job. The other main area that has received attention is care planning and although there is still some way to go good progress has already been made in this area.

What the care home could do better:

As mentioned above more work is still required before the care planning process has been fully updated. Attention also needs to be given to staff supervision so that the home can be sure that the staff are fully aware of how the needs of the service users must be met.

CARE HOME ADULTS 18-65 4 Maer Lane Market Drayton Shropshire TF9 3AL Lead Inspector Mike Moloney Key Unannounced Inspection 24th May 2006 07:30 4 Maer Lane DS0000020766.V294701.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 4 Maer Lane DS0000020766.V294701.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. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 4 Maer Lane Address Market Drayton Shropshire TF9 3AL 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) 01630 698092 cheryls@trident_ha.org.uk Trident Housing Association Care Home 10 Category(ies) of Learning disability (9), Learning disability over registration, with number 65 years of age (1) of places 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd February 2006 Brief Description of the Service: 4 Maer Lane is a purpose built residential home situated in Market Drayton, Shropshire. The home is owned and managed by Trident Housing Association. The Head Office is based in Birmingham. The home is registered with the Commission for Social Care Inspection to provide accommodation and personal care for a maximum of ten people with a learning disability to include one person over the age of 65. Ms Angela Jones has recently been appointed as the manager and has yet to apply for registration with the CSCI. The home has a service user guide which it make available to all stake holders and is available in an “easy read” version for those who may require it. The current range of fees is from £262 to £367 per week. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A range of evidence was used to make judgements about this service. This includes: information from the provider, records kept in the home, medication records, discussion with people who use the service, discussions with the staff team, discussion with the manager, tour of the premises, previous inspection reports, the quality assurance process and observation of care experienced by people using the service. The nature of the needs and disabilities of the service users concerned made ascertaining their views by direct means very difficult. Therefore the views of the managers and staff had to be relied on to a great extent. However, observation confirmed that the service users were calm and relaxed in their company approaching them freely when the need arose. What the service does well: What has improved since the last inspection? What they could do better: As mentioned above more work is still required before the care planning process has been fully updated. Attention also needs to be given to staff supervision so that the home can be sure that the staff are fully aware of how the needs of the service users must be met. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 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. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 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 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 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): EVIDENCE: No new service users have joined this home for some time therefore the key standards in this outcome group could not be fully assessed. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 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, 7 and 9 Quality in this outcome area remains poor as, despite effective efforts by staff to update some personal plans, the needs and wishes of some service users are not yet clearly identified and are therefore less likely to be met. EVIDENCE: A number of care files were looked during the inspection and it was clear that some care plans had been reviewed in depth and presented in a fashion that shows that the system is much more systematic than previously. There was more documentary evidence that the service users views as well as their families had been obtained and this was kept in a much more accessible manner. A number of the service users’ files had yet to be treated in this manner but there was positive evidence that every effort would be made to remedy this. However, the manager and her staff were observed to be constantly talking with the service users and explaining to them and asking their opinion about what was to happen in a manner that respected their ability to make choices for themselves. 4 Maer Lane DS0000020766.V294701.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): 12, 13, 15, 16 and 17 Quality in this outcome area is good. The service users are offered a range of activities and opportunities although it would be beneficial if it could be shown more clearly that these are consistent with their identified needs. They are also provided with meals that are to their taste and in quantities that are appropriate to them. EVIDENCE: As stated elsewhere in this report it was clear that a review of the contents and presentation of care plans is currently being undertaken by the home. When this is complete the home will be able to more easily evidence whether or not they are meeting the needs of the service users. However, it was clear from the documentation that was available and from conversing with and listening to the staff interacting with service users that a variety of activities both inside and away from the home as well as social or domestic are available to those living at the home. Examples were such things as bowling, Irish dancing, shopping, knitting and helping with domestic tasks. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 11 The records did, however, show that the service users views about their meals are ascertained as far as possible and these are taken into account when setting the weekly menus. This was confirmed in conversation with the staff on duty. The menus seen were well balanced and varied. The records also showed that the service users weights were also monitored on a regular basis. 4 Maer Lane DS0000020766.V294701.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 and 20 For some of the service users quality in this outcome area are only adequate, however, work that has been seen to have been completed for some of the others has made a significant difference in how their care can be monitored by the manager and her staff and therefore they can be sure that their needs are being met. EVIDENCE: Again, as reported elsewhere in this report, progress is being made in developing the care plans that will demonstrate more clearly that the needs of the service users are being met within this outcome group. A variety of records were found that confirmed that the home ensures that the service users have access to health care professionals as necessary. Equally talking with the staff and the manager and observing them interacting with the service users showed that they treat them with dignity and sensitivity. The records relating to the service users’ medication were looked at and it was seen that these were maintained in line with good practice and the medication was stored in cabinets that were appropriate to the type of medication being stored. The method of storage of medication that had been refused by the service users or dropped during issue prior to its return to the pharmacist was found to be inappropriate 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 13 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 Quality in this outcome area is good. The service users are protected from abuse and the staff enable their views to be taken into account despite the nature of their disabilities. EVIDENCE: The manager stated that no complaints had been made since the last inspection. Currently there is an issue relating to adult protection that the home had referred into the local procedures for such matters and they are managing this appropriately. The home had a copy of their complaints procedure and policies which complied with the local policies and procedures for the protection of vulnerable adults, both being part of the systems that ensures that the service users are listened to and protected from abuse, neglect and self-harm. The level of the disabilities of the service users means that most are unlikely to be able to access these formal policies but observation of the staff interacting with them and communicating between themselves indicated that they would be aware of any dissatisfaction expressed. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 14 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 and 30 The standard of the environment is good providing service users with an attractive and homely place to live. EVIDENCE: The home is situated in Market Drayton and is purpose built to accommodate people with a range of disabilities. The main laundry area is situated so that access is through areas that are not used for food preparation or consumption thereby reducing the risk of cross contamination. Walking around the home it was seen that everywhere was clean and well maintained with the grounds providing a similarly pleasant but secure area for the service users to be. The service users’ bedrooms were all seen and these were all pleasantly decorated and, according to those that could express their views, were very much to their liking. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 15 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, 35 and 36 The service users receive a good level of support from a skilled and caring staff team that could only be improved by those staff receiving regular professional supervision. EVIDENCE: Talking to the staff and looking at the staff rota showed that appropriate numbers of staff are on duty at all times. Part of the staff team is currently made up of agency staff but these are people who have worked at the home on a regular basis for some time, however, the manager pointed out that they are currently processing the applications of a number of potential new staff and when that process has been completed the reliance on agency staff should be much reduced. Talking to the staff and looking at their training records also confirmed they receive a range of training opportunities that they are encouraged to undertake. These included such things as the mandatory safety training through to qualifying through the NVQ system. This had ensured that half of the staff team had qualified to NVQ2 or above and therefore provided the service users with a trained staff team who could give them with the support that they require. The records that were used to show that this was the case had been compiled since the last inspection which had further enabled the home to develop an overall training and development plan. Looking at the 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 16 records of staff supervision did show that not all staff had been receiving regular professional supervision. No new staff had started at the home since the last inspection and therefore it was not possible to assess their recruitment procedures. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 17 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 and 42 This home is run and managed to a good level. There is a clear view of the role of the home that is supported by the company’s senior managers and effectively passed on to the staff. EVIDENCE: Ms Angela Jones has been appointed as the manager and has yet to apply for registration with the CSCI. The home is visited each month by a senior manager from the company who takes a critical look at various areas with a view to improving the service received by the residents. Reports are then produced and the Commission for Social Care Inspection are sent a copy. A variety of records were looked at that showed that fire precautions, portable appliances, water temperatures and suchlike are tested or monitored on a regular basis so as to safeguard the safety of the service users and the staff. Similarly records also showed and the staff available at the time of the 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 18 inspection confirmed that there is an ongoing programme of safety training for them. 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 19 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 N/A 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 3 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 N/A 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 x 2 x 3 x x 3 x 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 20 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 YA6 Regulation 15 (1)Sch 3 (1)(b) Requirement Timescale for action 30/09/06 2. YA6 15 (1) 3. YA6 15 (1)(2) 4. YA18 12 (3)15 (1) Care plans for all service users must be more detailed and contain all aspects of personal, social support and healthcare needs to ensure staff deliver the necessary care required in a consistent manner. This requirement remains outstanding from the last inspection. Care plans must set out how 30/09/06 current and anticipated specialist requirements will be met. This requirement remains outstanding from the last inspection. Care plans must be drawn up 30/09/06 with involvement of the service user, where possible together with their family and relevant others as appropriate and formally reviewed at least every six months and updated to reflect changing needs; and agreed changes are recorded and actioned. This requirement remains outstanding from the last inspection. The registered person must 30/09/06 ensure that service users’ DS0000020766.V294701.R01.S.doc Version 5.2 4 Maer Lane Page 21 5. YA19 13 (1)(a)(b) 6. YA20 13(2) 7. 8. YA36 YA37 18(2) 8 preferences with regard to their care are identified, recorded and regularly reviewed. This requirement remains outstanding from the last inspection. Service users must be supported to access health checks within the appropriate timescales. This requirement remains outstanding from the last inspection. The home must dispose of refused medication in a manner that is consistent with the guidelines produced by the Royal Pharmaceutical Society guidelines. The staff must be provided with regular and recorded professional supervision. An application to register the newly appointed manager must be submitted to the CSCI. This requirement remains outstanding from the last inspection. 31/07/06 30/06/06 30/09/06 30/06/06 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 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 4 Maer Lane DS0000020766.V294701.R01.S.doc Version 5.2 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. 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!