Inspection on 12/01/06 for 40a Manor Road

This inspection was carried out on 12th 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

40a Manor Road 17/10/08

40a Manor Road 02/11/06

40a Manor Road 14/07/05

40a Manor Road 20/12/04

40a Manor Road 13/05/04

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Ruskin Lodge

Clover House

Dystlegh Grange

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Cuerden Grange Rest Home

Springfield Cottage

Parkside

Park Lodge

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

CARE HOME ADULTS 18-65 40a Manor Road Upperby Carlisle Cumbria CA2 4LJ Lead Inspector Liz Kelley Unannounced Inspection 12th January 2006 02:00 40a Manor Road DS0000022569.V274700.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 40a Manor Road DS0000022569.V274700.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. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 40a Manor Road Address Upperby Carlisle Cumbria CA2 4LJ 01228 548118 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) The Glenmore Trust Mr Ian Andrew Waugh Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (5), Physical disability (3), of places Physical disability over 65 years of age (3) 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 5 service users to include: up to 5 service users in the category of LD (Learning disability under 65 years of age) up to 5 service users in the category of LD(E) (Learning disability over 65 years of age) up to 3 service users in the category of PD (Physical disability under 65 years of age) up to 3 service users in the category of PD(E) (Physical disability over 65 years of age) The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 14th July 2005 2. Date of last inspection Brief Description of the Service: 40a Manor Road is registered to provide residential care for 5 people with learning disabilities, two of whom also have a physical disability. The home is operated by the Glenmore Trust, a charitable organisation providing services for people with learning disabilities throughout North Cumbria. The house is leased from Impact Housing Association who were responsible for repairs and maintenance. 40a Manor Road is a large detached bungalow, situated in the Harraby area, on the outskirts of Carlisle. There are local shops within easy walking distance and a regular bus service runs into the city centre. Service users share the purchase and running costs of an adapted vehicle, which accommodates wheelchairs. There are five people resident in the home, all have a single room with washbasin. There is a large lounge, dining room and kitchen with a separate utility. There is also an office/sleep-in room used by staff. Lifting hoists, high/low beds, plus a walk-in shower are provided to promote independence and provide a safe environment. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over the afternoon period when all four residents were at home. Two members of staff were on duty, and a further two were met at hand-over of shift. The manager was also in the home spending time with residents. Time was spent with residents and staff talking informally. What the service does well: What has improved since the last inspection? What they could do better: A number of areas in the home had been identified by the manager as requiring up-grading and redecoration and he had succeeded in gaining extra funding from the organisation for this to happen in the next few weeks. This will greatly help the appearance of the home which had started to look a bit worn. Reseats had been involved in choosing carpets and new furniture and were pleased with this. Please contact the provider for advice of actions taken in response to this 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 40a Manor Road DS0000022569.V274700.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 40a Manor Road DS0000022569.V274700.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): 4 The Home has developed very good systems for assessing and introducing new residents which ensures that both the new resident and the home make the right choice and that care needs can be met. EVIDENCE: A new resident had recently been introduced to the house. This file contained a full community care assessment and additional notes on the homes assessment. This person was also given the opportunity to have numerous visits and to stay over night and consideration and compatibility with other residents was thoroughly examined. Daily notes and the communication notes recorded a series of visits to the home prior to moving in. Other residents files examined demonstrated a similar process of introduction to the Home. This had been handled in skilful and sensitive manner by staff as this resident had recently had a very bad experience at another care home were their needs could not be met. 40a Manor Road DS0000022569.V274700.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 and 9 The home had developed a good balance between risk-taking and a duty of care, and much of the dialogue is around rights, choices and developing positive options for residents. EVIDENCE: Residents are treated very much as individuals and their rights and needs respected and addressed. People living at the home are very well supported by staff to make choices and decisions and this results in them leading individual lifestyles. The use of person centred plans puts the resident at the heart of all activity in the house. Staff were observed on the day of the inspection supporting and guiding a resident through the decision making process of managing their money. Risk assessments were found to be very enabling in supporting an activity to take place as opposed to preventing it. The Home had also developed comprehensive strategies for minimising and managing challenging behaviours to minimise violent and aggressive outbursts. This is helped by the home having good links and advice from specialist professionals in learning disabilities. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 17 Residents are assisted to have a good quality of life and access to a variety of life experiences through a skilled and committed staff team. The meals in the home are of a good quality offering both choice and variety, and catering for special dietary needs. EVIDENCE: Residents were supported to maintain and develop relationships with the community. One resident had been supported to take a hobby that he used to take part in years ago, and staff had ensured that this was at a local sports centre and part of a class open to the general public. This had been part of the new staff teams effort to look at a more person centred ways of supporting people and is an example of good practice. Residents were observed interacting in a positive manner with staff and other residents. Dietary needs of residents are well catered for with a balanced and varied selection of food available that meets residents tastes and specialist. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 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 the following standard(s): Standards 18, 19 and 20 were assessed and met at the last inspection. EVIDENCE: 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 12 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 The home has a satisfactory complaints system which includes a number of different channels for residents to voice concerns. Staff have good knowledge and understanding of Adult Protection issues which protects residents from abuse. EVIDENCE: Staff had received training in the use of physical intervention procedures, which focused on diversion tactics rather than physical restraints, which were not used. Staff were encouraged to look for triggers and distraction measures and only when these failed was medication used to calm people down. This PRN medication had been agreed and reviewed by the residents medical Consultant. The home had polices and practices that safe guarded the handling of residents monies. Personal monies and records were examined and found to be correct, with the signatures of both staff and the resident. These areas, and training in Adult Protection safeguarded residents from abuse. The complaints procedure is available in different formats, large print and with pictures to assist understanding. A copy was held on each persons file, and was also included in the Occupancy Agreement and Service Users Guide for the home. Example of views being expressed by residents was seen on the inspection and the rights of individuals has a high profile in the Home. A recent example of this has been giving one individual more choice on his bed time, which had been influenced by another resident in the house. This was handled in a sensitive and skilled way but initially had put more pressure on staff but the outcome is more choice and a calmer atmosphere. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 13 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 A spacious purpose built bungalow provides residents with a comfortable, homely and safe environment that is pleasant to relax and spend time in. EVIDENCE: 40a Manor Road is a purpose built bungalow with ramped access and suitable adaptations for people with limited mobility. The home’s location offers easy access to local amenities, and is also on a bus route. The home is well maintained and of an attractive design which blends in with other houses in the residential area. Bedrooms were of a good size, which affords residents the option of spending time in their own rooms, as well as making use of the communal sitting room. A number of areas in the home had been identified by the manager as requiring up-grading and redecoration and he had succeeded in gaining extra funding from the organisation for this to happen in the next few weeks. All areas of the bungalow will be re-decorated and recarpeted. The assisted bath has recently been repaired and a new cooker is on order. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 14 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): 34 The recruitment practices of the organisation and the home ensure that residents are safeguarded and that staff have the qualities and aptitudes to work in social care. EVIDENCE: The Home followed the recruitment procedure of The Glenmore Trust. Staff files are now held in the home, contained all the relevant documentation and were clearly sectioned and well organised. The selection procedure included obtaining two written references, a formal interview and an informal interview involving service users, wherever possible. All staff had CRB disclosure checks. Upon appointment staff were issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. The Glenmore Trust has a code of conduct and all members of staff have a statement of terms and conditions. These are all good practices and ensure that residents are supported by a carefully selected and vetted staff team. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 15 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 and 42 Residents benefit from a service that is well-run by the manager and by the systems of the organisation, which ensure that service users are central, and their views are valued and acted upon. EVIDENCE: The Home operated to The Glenmore Trust’s Quality Assurance standards that included physical aspects of running the Home as well as monitoring the delivery of service. The provider, The Glenmore Trust, carries out regulation 26 monitoring visits and sends a copy of these into the Commission for Social Care Inspection. The records examined on the day of the inspection were deemed to be well ordered, relevant, appropriate and up-to-date for the smooth running of the Home and in meeting the needs of the residents. 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 16 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 X 3 X 4 4 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X X X 3 X X 3 X 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 17 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. 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 40a Manor Road DS0000022569.V274700.R01.S.doc Version 5.1 Page 18 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP 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. 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