Inspection on 17/05/05 for 44 Wilton Road

This inspection was carried out on 17th May 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

44 Wilton Road 06/02/08

44 Wilton Road 10/05/06

44 Wilton Road 05/12/05

44 Wilton Road 21/12/04

44 Wilton Road 25/08/04

44 Wilton Road 26/02/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Wilton Road (44) 44 Wilton Road Salisbury Wiltshire SP2 7EG Lead Inspector Alyson Fairweather Unannounced 17th May 2005 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. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Wilton Road (44) Address 44 Wilton Road Salisbury Wiltshire SP2 7EG 01722 410724 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) Rethink Vacant Care Home 8 Category(ies) of MD Mental Disorder (8) registration, with number MD(E) Mental Disorder - over 65 (2) of places Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 21st December 2004 Brief Description of the Service: 44 Wilton Rd is an 8 bedded home for adults who have chronic long-term mental health problems. The registered provider is Rethink, formerly NSF, and the building is owned and managed by Shaftsbury Housing Association. The building was formerly two houses, and has been very sympathetically renovated. The home offers easy access to local amenities and is situated in a quiet cul-de-sac. There is ample parking to the front of the home, and ramped access is available. There is a large secluded garden to the rear of the house, with a patio area and a conservatory. It is located in the city of Salisbury in Wiltshire and is within walking distance to the city centre. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over one afternoon in May. There were eight residents at home, most of whom were spoken to. Two staff members helped with the inspection. There is currently no registered manager at the home, although the post has been advertised internally. The inspector walked round the premises and examined several records, including care plans, medication records and staff training. What the service does well: What has improved since the last inspection? What they could do better: Risk assessments were available on residents’ files, and these included how to manage medication, information regarding diet and physical health as well as risks to mental health. One care plan did not have an up to date risk assessment on file, and the home has been asked to make sure that this is done at all times for all residents. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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) 2 Prospective residents have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. EVIDENCE: Considerable information from the referring mental health team is sent to the home when a new resident is planning to move in. Information is also received from medical teams and from various other professionals. Residents talk to staff at the home about their hopes for the future and what they would like to do with their daily routine before they move in, during the trial visits. The referring mental health teams provide a copy of the most recent Care Programme Approach (CPA) plan, which gives details of how the potential resident can best be supported with their mental health needs. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 and 9 Residents are fully involved in care planning and agree and sign any changes after a review. Individual risk assessments encourage and support residents to challenge and deal with problem areas in their lives. EVIDENCE: Care plans examined showed that residents had clearly taken part in reviews, and had signed their agreement with any changes, action plans or risk assessments made. One recent resident spoke of her move to the home, and how she was very happy living there. There were several risk assessments on file, and these included what to do when a resident didn’t want to take their medication, what to do if mental health symptoms got worse and how to manage careless smoking. One care plan did not have an up to date risk assessment on file. Although an old one was attached to a Care Programme Approach (CPA) report, it did not give details of any actions or controls which should be in place. The home should ensure that all risk assessments are up to date. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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) 12, 13, and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends, and are encouraged and supported by staff. EVIDENCE: None of the service users were in employment. However, one resident had been out for a coffee that day, another goes to group events, and one had bought a bicycle. Another resident had a keen interest in car maintenance. Leaflets were available about local courses and staff were aware of local facilities. Activities are discussed at residents’ meetings, and people go shopping, out for meals and have video evenings. One resident said they were pleased not to have to take part in things they didn’t want to do. Residents can entertain family or friends either in the privacy of their own bedrooms or in the communal areas available. Staff encourage and support links between residents and their families, although the frequency of contact varies depending on individual circumstances. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. Self medication is encouraged and supported as much as possible, and residents control a lot of their medication. However, a simpler way of recording medication given would make the system easier for staff and more safe for residents. EVIDENCE: All residents are registered with a GP and other health professionals are involved as required. All residents also attend mental health reviews on a regular basis, and care plans may be amended at this time. The home has a policy in place for all medication, including controlled drugs, and all staff have medication training when they first start work. When the medication of one resident was checked, the amount which should have been in the bottle was exactly correct. The system which is used to administer the medication is rather complicated, and involves staff copying out the name of the drug and then allocating it a code. This code is then written out again when the drug is given. When talking with staff it was agreed that this system left staff open to error, and that a more simple system should be tried. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 standard(s) 23 The arrangements made by the management team and staff relating to risk assessment ensure that the safety and welfare of clients are protected. The policies and procedures the agency has in place try to ensure that clients are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. Three staff members have recently received training in the protection of vulnerable adults and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff. Risk assessments are in place for all residents. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 standard(s) 24 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: 44 Wilton Rd was formerly two houses, and has been very sympathetically renovated. It is a comfortably furnished home with large airy rooms. Residents’ bedrooms were homely and each contained individual personal items. One resident chose to watch television in the bedroom in the afternoon, and invited the inspector to see the room. There is a large secluded garden to the rear of the house, with a patio area and a conservatory. There is ample parking to the front of the home, and ramped access is available. The old downstairs shower room is to be revamped, and building estimates are being sought for the work. It was clean and hygienic, with policies and procedures in place for the maintenance of the building. Residents are encouraged to help with household chores, although staff take these over when necessary. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 35 Residents’ individual and joint needs are met by staff who have had induction and some specialist training, and are undertaking NVQ. EVIDENCE: Staff files were not available during this inspection, but the staff member on duty stated that staff had done training on Suicide Awareness, Antidiscriminatory Practice, Cultural Awareness, and several staff were undertaking NVQ level 3. Three staff had recently done Adult protection training, and an Appointed First Aid course was due to start. All staff are also due to go on fire training. It was not possible to check whether training had been given on care planning or key working, but this will be checked on at the next inspection. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 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) 37 and 42 The lack of a full-time, permanent manager has been helped by staff who are well known to the residents, giving them a sense of stability. The home’s policies and procedures, and the health and safety checks carried out, mean that residents live in a safe environment. EVIDENCE: A part time manager has been running the home since the resignation of the last manager. The post has been advertised and it is hoped to fill the vacancy very soon. Staff are to be commended for their hard work in trying to establish a sense of stability for residents. All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell and emergency lighting are tested regularly, and after all staff have had their fire training, a designated fire officer will be appointed. Rethink also undertakes a quarterly Health and Safety Audit of the home. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wilton Road (44) Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 17 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 9 Regulation 13 (4) (b) Requirement All risk assessments must be kept up to date. Timescale for action 17/07/05 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. Refer to Standard 20 Good Practice Recommendations It is recommended that some thought is given to introducing a simpler system of recording the medication administration. Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 18 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 Wilton Road (44) D51_D01_S28684_WILTONROAD(44)_V211199_170505_Stage4.doc Version 1.30 Page 19 - 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. 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