Inspection on 28/07/05 for 40 Cooperative Street

This inspection was carried out on 28th July 2005.

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

40 Cooperative Street 21/10/08

40 Cooperative Street 20/08/07

40 Cooperative Street 05/02/07

40 Cooperative Street 12/12/05

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 Wendy Jones Unannounced 28 July 2005 11am 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 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 Stationary 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 E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 40 Cooperative Street Address Stafford Staffordshire ST16 3DA Telephone number Fax number Email 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 Staffordshire County Council, Social Care and Health Directorate Mrs Karen Jane Webb CRH 11 Category(ies) of DE 4 registration, with number LD 11 of places LD(E) 1 MD 3 PD 5 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 03/02/05 Brief Description of the Service: 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 11 adults who have learning disabilities and complex needs. The service provides a high standard of support to individuals with behaviours which are challenging.The residential service is in the same building as a day service which is accessed by residents.The residential provision is divided into two elements, ground floor provision for 3 residents and first floor provision for the remaining 8.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. Bedrooms are personalised and reflect their tastes and interests.Services provided include laundry, catering and domestic services which are provided to a good standard. Staffing levels are adequate with a flexible approach taken to supporting individuals. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit carried out on 28 July 2005. Information for the inspection was from, discussion with the manager; from care plans, staff rota’s, staff files, training records; from fire safety record and from observation. During this visit most of the service users were receiving day care services at the on site day centre. The service provides for 11 service users with learning disabilities who have complex needs and may exhibit challenging behaviour. What the service does well: The service provides care and accommodation for service users who have learning disabilities and complex needs, who exhibit behaviours that are challenging. It also provides a day care service providing educational, recreational and occupational activities. Care plans were detailed with evidence of regular review. Strategies for behavioural management have been developed and incidents of restraint decreased. Vulnerable adults and complaints procedures were in place. The service provides a safe environment for service users to live. The health care needs of service users were met. The systems for the safe storage and administration were adequate. Staffing levels are high a recent recruitment drive has significantly reduced the staffing vacancies. Risk assessments are detailed and provide staff with the information they require to support service users. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 6 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 E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 standard(s) 1,2. The Statement of Purpose and Service User Guide provide prospective service users with the information they need to make informed decisions about moving in to the home. The service provides care and accommodation for service users who have a learning disability and who present with challenging behaviour, the evidence form the inspection was of a service that met the needs of the majority of service users. EVIDENCE: The service has a Statement of Purpose and Service User Guide. Since the last inspection a review of both documents has been undertaken to reflect the change in Responsible individual as head of Adult Services for the authority. It was identified during this inspection that the needs of one service user were no longer being met by the service. This matter had been discussed with the social worker and specialist placement team for action but the situation had continued. The service had obtained an independent advocate on behalf of the service user, to ensure that the rights of the individual were met. It was agreed to write separately to social services regarding this matter. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 standard(s) 6,9. Care plans were in place and were detailed, addressing the assessed needs of service users. Risk assessments were detailed providing staff with the information they need to reduce any risks to service users. EVIDENCE: A sample of care records indicated that the assessed needs of service users were known and appropriately addressed by the service. The service operates a person centred approach to care planning, the model has been developed throughout the Staffordshire Council Homes. The information in the records provides guidance relating to the needs of service users. Following discussion it was agreed with the manager that consideration should be given to the development of a 24 hour plan of care or “ a day in the life of” this model supports the PCP approach to care. Risk assessments for individual were in place to minimise known risks to service users. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 standard(s) x EVIDENCE: This section was not inspected during this visit. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 11 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 standard(s) 19,20, The health needs of service users were being met. The systems for the safe administration of medication were good, assuring the well being of service users. EVIDENCE: The records showed that the health needs of service users were being met; with regular health checks, medication reviews and input from health specialist services. The service operates a monitored dose system for the administration of medication. All senior staff were reported to have undertaken a distance learning medication course. Assessment of staff knowledge and understanding of the organisations medication policies and procedures is also undertaken. Records showed that protocols were in place for medication prescribed to be used as required, these had been agreed with the prescribing GP or consultant.. Staff were also reported to have received training in the administration of Rectal Diazepam and procedures were in place for staff to follow in the event of a crisis. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 12 Medication was stored appropriately, in a secure facility, records of medication administration were accurately maintained. None of the service users resident at the home self medicated. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 standard(s) 22,23. A complaints procedure was in place with evidence that service users would be supported to express and concerns they had. Arrangements for protecting service users are satisfactory placing them at possible risk of harm or abuse. EVIDENCE: The service has a complaints procedure and adheres to the procedures for the protection of vulnerable adults agreed in Staffordshire. New staff receive training in the protection of service users, recognising and reporting abuse in the induction programme for the home. Existing staff have not received formal training but the procedures, including the document “no secrets” were reported to be discussed at staff meetings. The manager also reported that she had plans to invite the Staffordshire social services’ new Vulnerable Adults officer to provide a staff training session. No vulnerable adults investigation have been undertaken since the last inspection. Two staff files seen during this visit, confirmed that appropriate checks were undertaken by the organisation and service to safe guard service users. Due to the nature of the service and the complexity of service user behaviours that challenged the service, staff have been trained in behavioural management techniques which includes restraint. The manager reported that training was up to date and the service were looking to improve their practice 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 14 by introducing more pro-active rather than reactive strategies. Training is being provided. Monthly audits of the number of restraints that have occurred are now being undertaken, the records seen indicated that there had been a reduction in the incidents of restraints. It was recommended that a copy of the audits is forwarded to the CSCI. The individual records of behavioural management strategies were of a very high standard, 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 standard(s) 24. The service provides a comfortable and safe environment for service users. EVIDENCE: A detailed environmental inspection was not undertaken during this visit, the details of the service were taken from the homes Statement of Purpose. The service is provided in a 1970’s style two storey building that is clearly a social service establishment and not an ordinary dwelling. Social services have upgraded and refurbished the environment over the years, and more recently, since the last inspection all the external doors have been replaced, an air conditioning system has been fitted, a garden area has been created and a pin point call system introduced. The manager indicated that the service has plans to develop a sensory garden, having been successful in acquiring some monies from the Princes Trust. The environment was not inspected during this visit, the following information is taken from the service Statement of Purpose. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 16 The service has a day care centre on the ground floor, care, administration and management offices and a three bedded flat, for those service users who may have mobility difficulties and who may be working towards more independent living. There is also a main kitchen and laundry on this floor. The main living accommodation is on the first floor of the home, where the service users have access two lounge/dining rooms and a kitchenette. Bathing facilities are provided on each floor, and have assisted facilities, a separate shower facility is available on the first floor. Additional toilets are provided in sufficient numbers on both floors. The service has a shaft lift which enables service user to access all areas of the home. It also has adaptations and specialist equipment to aid those with physical disabilities. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 17 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35. Recruitment procedures were robust providing adequate checks to ensure that service users are safe guarded. Staffing levels were good providing service users with sufficient support to enable them to develop. EVIDENCE: The manager reported that a recent recruitment drive had been successful and staff vacancies had been reduced to 3 care vacancies, 1 support service administrator and 1 domestic vacancy. The records showed that there were 6 care staff deployed during the early shift up to 3.30pm and 5 staff from 2pm-20pm, in addition the manager was deployed from 9am-8pm, a senior care from 7.30am-2.30pm, 1 from 3pm8pm and another from 2pm-11pm to sleep in. The service provides two waking night staff. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 18 A sample of staff records indicated that appropriate checks were carried out prior to employment. Areas of good practice were also identified and discussed relating to seeking additional verbal references, tracking and discussing when an employment gap had been noted. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 19 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The health and safety of service users was assured by the systems and monitoring in place. EVIDENCE: The manager has 14 years experience in management and care and has a management qualification. Service users files included risk assessments and comprehensive behavioural management plans, which included explicit guidance for control and restraint techniques. Fire safety records were appropriately maintained. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 2 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x 3 3 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 40 Cooperative Street Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 21 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 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. 1. 2. 3. Refer to Standard 23 2 6 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. Give consideration to the development of a day in the life of. 40 Cooperative Street E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Stafford - 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 E51-E09 S32165 Cooperative Street 220705 V242121 Stage 4.doc Version 1.40 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. 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