CARE HOME ADULTS 18-65
45 Watson Road 45 Watson Road Blackpool Lancashire FY4 2DB Lead Inspector
Christopher Bond Unannounced Inspection 30 November 2006 09:30
th 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service 45 Watson Road Address 45 Watson Road Blackpool Lancashire FY4 2DB 01253 347810 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) Mrs Mary Catherine Webster Mr Robert Francis Webster Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: 45 Watson Road is a care home registered for five adults who have a learning disability. The home is situated in the South Shore area of Blackpool, not far from the Pleasure Beach. All of the bedrooms are large with good views. There are garden areas to the front side and rear of the house where people can sit out in good weather. The house is close to several local shops, which are within walking distance. There is a small park not far away and busses run into Blackpool and to other parts of the Fylde coast from close by. The house has a small driveway and visitors to the home are able to park in the streets close by. There is a statement of Purpose/Service user Guide, which is given to all prospective clients. This written information explains the care service that is offered, who the owners and staff are and what the client can expect if he or she decides to use the home. At the time of this visit, (29/11/06) the information given to the Commission showed that the fees for care at the home are £311.30 per week, with added expenses for chiropody. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place over a total of four hours. Comment cards had been sent out prior to the visit and comments from the completedforms have been used in this report. A tour of the home took place, which included bedrooms, lounge and dining areas, and bathrooms. Administration records for the residents and staff were examined.Safety records and training records were also examined. The inspector spoke to the manager and care staff. All of the residents who lived a the home were spoken to. What the service does well: What has improved since the last inspection?
The manager has completed two nationally recognised qualifications in management (National Vocational Qualification level 4 and the Registered Managers Award). This helps to ensure that he has the knowledge, skills and ability to run the home appropriately and professionally. Most of the care staff now have a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). This helped to make sure that the residents were properly supported. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1 and 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Careful and comprehensive admission procedures help to ensure that this home can meet peoples needs properly. Current and potential service users have the information they need to make an informed choice about whether or not the service is able to meet their specific needs. EVIDENCE: It was clear that people wishing to live within the scheme had the information to decide whether the service is right for them. There was a Service User Guide and a Statement of Purpose for the service users and their representatives to read. This document contained all the important information that a service user would need to make an informed decision about whether or not the service is able to meet their specific needs. Each of the service users had been assessed before living at the home so that a decision could be made as to whether the staff could care for them properly and address their specific needs. There was a copy of this assessment on each of the residents’ personal information files. The placing authority also undertook assessments on all of the residents at this home. These took place on a yearly basis and helped to make sure that peoples’ needs were being met properly and that the home could provide the correct level of support. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7, 8 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are confident that their opinions and wishes are respected and listened to. Good care planning helps the residents to maintain control of their lives and make decisions about things that affect them. EVIDENCE: Everybody who lived within this home had an individual care plan. The plans set out in detail the actions that needed to be taken by care staff to ensure that all aspects of the health, personal and social care needs of the service user were met. Everybody’s plan was reviewed on a monthly basis and information on each resident was updated after the review process. This helped to make sure that the service was meeting people’s current needs. It would be nice to see that the plans were based on a ‘person centered’ format. This would mean that the format of the plan would be specifically for individual service user and would be based entirely around their interests, needs and abilities. The plan would also be presented from the residents’ point of view, in a format most suited to the resident’ knowledge and skills. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 10 The inspector spoke to all five of the residents. It was clear that all of the residents were involved in making decisions that affected their lives. One resident said “I can choose what I do every day. That’s the way I like it.” The residents also described how they were involved decisions that affected their lives. All said that they had an excellent relationship with the manager and could speak to him whenever they wanted about issues that affected them. There were also regular residents meetings and the minutes of these were written down and saved to ensure that important items were followed up. The residents’ plans all had risk assessments attached. This meant that any activity where risks were taken was checked out. Controlled risk can be good for the development of adults who have a learning disability as long as any element that may affect safety is closely monitored. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are offered opportunities to participate in ordinary activities in the community. Friends and family are made welcome within the home, which helps to maintain positive relationships. EVIDENCE: All of the residents had valued day activities. Two residents were employed and others enjoyed college courses. One of the residents was enjoying education in English, Mathematics and Health and Safety. It was good to see that the residents were participating in valued, integrated activities both during the day and in the evening. Staff also helped the service users to participate in hobbies, interests and pastimes of their choice in the local community. This meant that people who had a learning disability were able to use the facilities and resources that were available to all in society. Four of the residents were able to enjoy life outside of the home without staff support. One resident had recently returned from a short stay with his family.
45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 12 Another resident regularly went on holiday to Wales to stay with his family. The manager was fully aware of the importance of maintaining family contact whenever possible. It is important that valued family involvement takes place in order that positive relationships are kept. There were many good examples seen of people being treated with respect and dignity. People were being spoken to with consideration. The service users were given time to respond and were confident in voicing their opinions and feelings. The support workers who were spoken to were fully aware of good practice and how people should be treated. It is important that people who live within services are respected as valued members of the community. All of the five residents who were spoken to said that they found the food within the home very good. One resident said, “ the food is lovely, we have food from all over the world.” The residents were able to choose what food was cooked at mealtimes and people generally had a nutritious and healthy diet. It would be nice to see that the residents were more involved in preparing their meals. This is a valuable skill. One of the residents said, “I don’t cook, it’s usually cooked for us.” All of the residents were assisted in filling out a care survey that was sent to them before the inspection. All of the residents wrote that they were able to make decisions about what they do each day. Residents also said that they could do what they wanted to do during the day, in the evening and at weekends. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported well and their physical and emotional health needs are met. Medication is handled safely by trained staff. EVIDENCE: There were no residents at the home who required assistance with personal care. All of the residents were self-caring altough verbal advice was sometimes given regarding appropriate dress. It was seen that the manager and staff at the home addressed the residents with respect and treated them with dignity. The residents were encouraged to use all the facilities and resources in the community that they are entitled to, and not prevented from doing so because they have a disability. One of the residents had experienced a life-threatening accident whilst travelling to their place of work. This meant that a stay in hospital was necessary. It was clear that every effort was made to ensure that this person had a friendly face with them on a daily basis whilst in hospital. The manager and care staff who were spoken to talked of their worry and concern when
45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 14 things were not going well. There was a clear feeling of closeness, and a family atmosphere was encouraged throughout the household. None of the residents were responsible for their own medication. Systems were in place that ensured that medication was handled correctly and professionally. The records of all the people who received medication were seen andhad been appropriately completed. The care staff had completed training in the correct handling of medication. This helped to ensure that the residents were safer. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are protected from harm by good procedures and training in safeguarding vulnerable adults. The residents put their trust in the staff at the home and feel that they are respected and listened to. EVIDENCE: All of the residents who replied to the care survey sent by the Commission for Social Care Inspection before the visit said that they knew who to speak to if they were not happy. There was a good complaints procedure and everyone who was interviewed said that they were happy that the manager would address their concerns properly. It was clear that concerns were being dealt with before they developed into full complaints. The manager spoke to all of the residents on a frequent basis. All of the residents spoke of their trust in the manager. There was a naturally trusting atmosphere where residents knew that their worries would be addressed appropriately and properly. There had been some training in the protection of vulnerable adults. The manager and the care staff said that they understood the procedures involved in safeguarding people. When asked if they felt in safe hands, one of the residents said, “I’m really happy here and I feel really safe and secure.” 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 28 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The residents live in a warm, homely and safe environment. EVIDENCE: Four of the residents showed the inspector their rooms. These were all large and had lots of personal possessions such as books, photographs, ornaments, televisions and music equipment. One of the residents had some framed certificates on her wall that outlined her achievements. All of the resident who were spoken to were proud of their rooms and expressed their happiness that they lived there. There was a large communal lounge where the residents could spend time together watching television or listening to music. The kitchen area was the centre of the house and residents and staff were sat chatting and socialising together. This was where meals were eaten. The residents were confident in expressing their views in a happy, inclusive environment. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 17 The house was very well maintained and furnished. It was a cold day and the house was very warm and inviting. There were areas at the back of the house where the residents could sit out when the weather was warmer. The home was exceptionally clean throughout. This helped to ensure that the residents lived in a safe and hygienic environment. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31, 32, 33, 34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by well trained, knowledgeable and competent care staff. Good recruitment practices meant that residents were protected from unsuitable staff working in the scheme. Staff were supported properly in their roles. EVIDENCE: Care staff files showed that recruitment was being carried out correctly and that information on each support worker was up to date and accurate. Criminal Record Bureau disclosure checks were carried out before employment and proper references were asked for. This helped to ensure that service users were safer. Staff files were examined and all of the files contained good information about the identity and skills of the care staff. Records showed that there were enough care staff employed to ensure that the assessed needs of the residents were properly addressed. The residents said that there were usually enough care staff around to help them do the things that they wanted to do. Most of the care staff had a nationally recognised qualification in care (National Vocational Qualification level 2 or 3). There were regular training
45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 19 courses that supplemented the knowledge of the care staff. This helped to make sure that the residents were properly supported. The staff that were spoken to felt well supported and valued. Each of the care staff had a job description, which helped to clarify their role and responsibilities within the home. All of the care staff received regular personal, recorded supervision where individual support was given and where work issues could be discussed. The care staff who were spoken to were able to confirm this. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The residents are protected and safeguarded by good management practice and a well maintained home. EVIDENCE: It was clear from looking at the policies, procedures and management of this home that it was well run. It was also clear, through talking to the manager, residents and staff that the home was being run in the best interests of the people who lived there. The residents were clearly happy and content with their support. One of the residents said, “I’m very happy living here and I don’t ever want to leave here.” Good records were being kept of safety checks within the home. These showed that professionals were checking the lift, electric and gas equipment and the fire alarm system regularly. This helped to ensure that the residents lived in a
45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 21 safe home. There had been training on health and safety issues within the past 12 months. The manager had completed two nationally recognised qualifications in management (National Vocational Qualification level 4 and the Registered Managers Award). This helped to ensure that he had the knowledge, skills and ability to run the home appropriately and professionally. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. 1 Refer to Standard YA6 Good Practice Recommendations Care plans for all residents should move to being ‘person centred’ and in a format more appropriate to their individual interests, needs and abilities. 45 Watson Road DS0000009880.V316545.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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