Inspection on 12/12/05 for 40 Cooperative Street

This inspection was carried out on 12th December 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

40 Cooperative Street 21/10/08

40 Cooperative Street 20/08/07

40 Cooperative Street 05/02/07

40 Cooperative Street 28/07/05

40 Cooperative Street 28/02/05

40 Cooperative Street 03/08/04

40 Cooperative Street 21/02/04

40 Cooperative Street 09/10/03

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

CARE HOME ADULTS 18-65 40 Cooperative Street Stafford Staffordshire ST16 3DA Lead Inspector Ms Wendy Jones Announced Inspection 12 December 2005 13:15 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 40 Cooperative Street Address Stafford Staffordshire ST16 3DA 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) 01785 252645 01785 245903 kwebb@staffordshire.gov.uk Staffordshire County Council, Social Care and Health Directorate Mrs Karen Jane Webb Care Home 13 Category(ies) of Dementia (4), Learning disability (13), Learning registration, with number disability over 65 years of age (1), Mental of places disorder, excluding learning disability or dementia (3), Physical disability (5) 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: 40 Co-operative street is located in a residential area of Stafford. Close to the town centre, it is well situated for access and public transport. The unit is registered for 13 adults who have learning disabilities and complex needs. The service provides a high standard of support to individuals who exhibit behaviours that are challenging. The residential provision is divided into three elements, ground floor provision for 3 residents, first floor provision for up to 8 and a two-bedded house in the grounds of the main house. The home provides a good standard of accommodation, décor is well maintained throughout. There are two communal lounges on the first floor and one on the ground floor. These offer space for residents and opportunities for staff to facilitate work with small groups. Services provided include laundry, catering and domestic services and the home has its own day care facility on the ground floor. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection conducted on 12th December 2005. Information for the inspection was provided from discussion with the manager; from information provided in the pre inspection questionnaire; feedback from 7 relatives and service users; from inspection of records and documentation relevant to the inspection process; from observation of the physical environment and of staff/service user interactions. This inspection was conducted in the main building only. Since the last inspection a two-bedded property in the grounds of the main building has been registered with the Commission for Social Care Inspection to accommodate two additional service users. Dependency levels of the service user group was described as high, all had communication difficulties and all required a level of support in meeting their personal care needs. 10 service users were described as presenting challenging behaviour. What the service does well: The service has achieved a Charter Mark Award and the staff team have received recognition in the Authorities Staff Award Scheme. The service has a Statement of Purpose and Service User Guide. A review of the Statement of Purpose has been undertaken to reflect the increase in service user numbers agreed when the two-bedded house in the grounds of the main building was registered. The Service User Guide was under review at the time of the visit, with plans to produce it in a more user-friendly format. The admission documentation was accurately maintained with evidence that pre-admission assessments had been completed. Care plans were detailed and reflected the assessed needs of service users and there was evidence of regular reviews of care plans. A range of social opportunities were offered outside of the home and service users were supported to maintain contact with relatives and friends. The health and personal care needs of service users were recorded and individuals were supported to access regular health appointments. Procedures for the protection of service users were in place, training for staff was planned, and procedures promoted service users to comment on the service they received. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 6 The environment was well maintained, clean and tidy, providing service users with a comfortable home. The staffing arrangements were satisfactory providing sufficient staff to meet the needs of service users. The standard of staff training was good. The health and safety of service users is assured by effective policies and procedures and risk assessments, by training and by good record keeping. 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. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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 The homes Statement of Purpose and Service User Guide were good, providing service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to be made. EVIDENCE: The Service User Guide was under review to provide a more user-friendly document, a copy of the revised guide must be provided to the Commission for Social Care Inspection. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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. There was a clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: Each service user was allocated a key and co-worker, to ensure that service users’ needs were being appropriately met. Monthly reviews of care plans were undertaken. A sample of care plans indicated that service users’ needs were being appropriately met. There was some concern expressed regarding a service user whose initial placement had been for a short period of time. The manager felt that the service user had outgrown the service and would benefit from an alternative placement, but despite discussions with care management and social services there did not appear to be progress in finding a suitable alternative. It was agreed that the Commission for Social Care Inspection would contact social services regarding this issue. The service user was not available to talk to during this visit. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 10 There was evidence of good pre- and post-admission assessment. 24-hour support plans were in place and there was evidence of regular reviews. Formal 6-monthly reviews of care were undertaken with the service users. Some service users were more involved in care planning than others, dependent on their ability to engage, although efforts were made to include all service users. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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): 12,13,15,16,17 Service users were supported to access social and recreational opportunities. Dietary needs of service users are well catered for, with a balanced and varied selection of food available that meets service users’ tastes and choices. EVIDENCE: Records showed that service users were supported to engage in a number of recreational and social activities outside of the home. Including visits to a local leisure centre, gyms, shops, pubs, college and day services. In house the service has its own day care centre for 8 service users. Members of the care staff team and the day care team work with service users in this facility, which also is open to 1 day care service user. From discussion it was established that service users are supported to maintain contact with relatives and carers - this was confirmed from the relative feedback. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 12 Meal times were scheduled at regular intervals, but were also flexible. Breakfast from 7.45am-9am, lunch 12noon-1pm, evening meal 4.45pm-6pm and supper 8.45pm-10pm. A choice of main meal was available at all meal times, and special diets were catered for if required. A catering team prepared and cooked the main meal of the day and alternatives were available at all meal times. Service users had access to a small training kitchen where they were supported to prepare a meal. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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): 18,19,20 Personal and health support in this home is not offered in such a way as to promote health and protect service users’ privacy dignity and independence. The systems for the administration of medication are good with clear and comprehensive arrangements being in place to ensure service users’ medication needs are met. EVIDENCE: Dependency levels were reported to vary. All service users exhibited some challenging behaviour, with 10 service users reported to exhibit behaviour considered to be extreme. Service users required some assistance with self-help and personal care, washing, bathing and toileting. 2 service users were reported to have a hearing impairment; all service users had some degree of communication difficulties. Specialist communication methods such as Makaton and object referencing were used in the home. 3 service users have mobility difficulties and have access mobility aids in and outside of the home. The service is registered with the autistic society, as a number of service users were described as having autistic tendencies. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 14 The records showed that service users were supported to attend health related appointments and received health checks regularly. 4 senior staff had been trained to cut service users’ nails where a risk assessment determined that the risk was low and other service users received a check-up from the NHS chiropody service 4 times per year. Referrals to specialist health services had been made where necessary. Service users had involvement from dieticians, speech therapists, audiologists, behavioural and psychology services. A health facilitator employed by Mid Staffs PCT was supporting service users to access mainstream health services and improve the channel of communication and understanding between the service and the Health Authority. The service medication policy had been revised. The manager had completed certificated training in the safe administration, storage and management of medication. Other staff had received training in-house with an assessment of competence. It was confirmed that all staff responsible for the administration of medication must were receiving certificated training. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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): 22,23 The home has a satisfactory complaints system with some evidence that service users feel that their views are listened to and acted upon. Arrangements for safeguarding service users were satisfactory, providing protection from possible risk of harm or abuse. EVIDENCE: One complaint had been received at the home during the last inspection and the matter had been resolved satisfactorily - this was confirmed from the relatives’ feedback records. A complaints procedure was displayed in the home and had been included in the Service User Guide and Statement of Purpose. All relatives who returned feedback forms confirmed that they had been made aware of the complaints procedure. The Commission for Social Care Inspection have not received a complaint about this service. Vulnerable Adults procedures were in place and no referrals had been made under these procedures during the 12 months prior to the inspection. Staff had received guidance in reporting suspected abuse. For clarification it was agreed that any incident with a service user who sustains an injury as the result of an accident and is treated or referred to the Accident and Emergency department must be reported under regulation 37. In addition any physical restraint of service users must also be reported. In addition a monthly audit of incidents of restraint will be provided to the Commission for Social Care Inspection. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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, 28 30. Recent investment has further improved the facilities at this home creating a comfortable and safe environment for those living there and visiting. EVIDENCE: 40 Co-operative street is a two storey 1970’s building situated on the outskirts of Stafford Town Centre. 40a is a three-bedroom detached property which is adjacent to the main building. There are 8 single bedrooms on the first floor, 3 on the ground, within a self-contained flat; and 2 bedrooms at 40a. None of the bedrooms provide en-suite facilities but all had vanity units and those seen during this visit met the standards in relation to space, furnishing and fittings. There were sufficient bathing, shower, toilet and communal facilities. This inspection focussed on the first floor of the main building, but did not include a detailed inspection of the home. The accommodation included a main lounge/dining room and an additional semi-independent flat, where up to three service users could be supported to prepare and cook their own meals. The environment was clean and tidy throughout. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 17 Since the last inspection a sensory garden had been developed with support from the Princes Trust Charity and a ramp has been provided to the main entrance of the home for ease of access for those service users with mobility difficulties. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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, 33,35 Staff morale is high resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: Staffing on the day of the inspection included: Care staff 3x 7.30am-2.30pm 3x 7.30am-3pm 1x 9am-4pm Manager 1x 7.30am-2.30pm Care staff 2x 3pm-10pm 2x 2.45pm-10pm 1x 2.30pm-10pm Manager 1x 2pm-11pm, sleep over. Staffing was supplemented by 4-day care staff and a driver, and additional catering and domestic staff. The care managers hours were supernumerary. The budgeted weekly hours were reported to be 564 plus a percentage for sickness and annual leave. A number of service users were funded for additional 1:1 time, which equated to 151 hours per week. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 19 A new induction had been introduced by the organisation and included elements that met the recommendations for Learning Disability Services. Information provided in the pre-inspection questionnaire and from discussion with the manager showed that 48 of the staff team had achieved NVQ 2 in care qualifications or above and 6 staff were doing the training. All domestic staff were also taking an NVQ qualification. Since the inspection the manager reported that 15 of the 30 staff had NVQ level 2, and 4 staff had achieved NVQ level 3. The manager provided information confirming that mandatory training was up to date and ongoing. She also confirmed that Vulnerable Adults training was to be provided. Staff meetings were planned every 2 weeks and records available confirmed this. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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): 39, 40, 41, 42 The manager is well supported by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. The health and safety of service users was assured by robust policies and procedures and regular monitoring of equipment. EVIDENCE: Quality audits have been undertaken and have included seeking the views of service users and relatives. An action plan based upon the outcome of this audit had been produced. Policies and procedures required by regulation were in place. Since the last inspection a new policy on Diversity and Equality and working with volunteers had been devised, and others had been reviewed. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 21 Information provided in the pre-inspection questionnaire indicated that all health and safety checks had been undertaken, including servicing and testing of equipment and any recommendations arising had been implemented. Fire safety checks had been recorded as required and recommended, staff fire drills and training were undertaken at least twice per year for day staff and 4 times per year for night staff. A fire safety risk assessment was in place. All senior staff were reported to have received fire marshal training. A new emergency call system had been fitted. A sample of service users finances, showed that monies were appropriately managed at the home. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 X X X X Standard No 22 23 Score 4 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X X 3 X 4 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 40 Cooperative Street Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score X X 3 3 3 3 X DS0000032165.V266338.R01.S.doc Version 5.0 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. 1 Standard YA1 Regulation 6 Requirement Provide a copy of the revised Service User Guide to the Commission for Social Care Inspection. Timescale for action 12/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA23 YA6 Good Practice Recommendations Copy the monthly audits of service user restraint to the CSCI. Continue to support the service user identified to access a more appropriate service. 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 40 Cooperative Street DS0000032165.V266338.R01.S.doc Version 5.0 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. 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