Inspection on 26/05/06 for 46 Bath Road

This inspection was carried out on 26th May 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 no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

46 Bath Road 09/11/07

46 Bath Road 06/12/05

46 Bath Road 28/06/05

46 Bath Road 07/01/05

46 Bath Road 18/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 46 Bath Road Longwell Green South Glos BS30 9DG Lead Inspector Grace Agu Key Unannounced Inspection 26th May 2006 09:00 46 Bath Road DS0000003384.V299720.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 46 Bath Road DS0000003384.V299720.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. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 46 Bath Road Address Longwell Green South Glos BS30 9DG 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) 0117 9601491 0117 9709301 admin@aspectsandmilestones.org.uk Aspects and Milestones Trust Mrs Josie Bolt Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 6 persons aged 18 years and over. May include persons aged 65 years and over. 6th December 2005 Date of last inspection Brief Description of the Service: 46 Bath Road is an older style Bungalow that was renovated about 7 years ago prior to becoming a Care Home. Access is via a private lane to the rear of the property. The home is located in a residential area of the most southerly aspect of South Gloucestershire. It is a quarter of a mile to the local shopping area of Long-well Green, other local amenities and post office. It is 4 miles from the City Centre. The home has a large lounge area, a spacious kitchen and a large general communal area. There are 6 bedrooms and sufficient toilet, bathing and sluice facilities are provided The small garden at the front of the property is not used and is currently maintained with a shingle surface. There is a large elevated grass area at the rear of the property and car parking space between this and the house. The home is a part of Aspects and Milestones Trust, a registered Charity providing residential care for people with Learning Disability and Mental Health problems. The Home provides residential care for 6 adults with learning difficulties. The manager at the time of inspection was Josie Bolt. Fees range from £i052.00 per week. 46 Bath Road DS0000003384.V299720.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 which took place over eight hours and was undertaken to review the requirements made at the last inspection and to review the care practice to ensure that it is in line with the legislation and that best practice is followed at the home. At the last inspection six requirements were made, it was pleasing to note that the home had made efforts to ensure that most of the requirements were met. At this inspection it was noted that there were minor discrepancies in relation to safe administration of medications this was remedied before the end of the inspection. Three residents, three staff members and two visitors were spoken with. A number of records were viewed and a tour of the building was undertaken. The residents were noted to be relaxed and staff were noted interacting with residents in a dignified and respectful manner. What the service does well: What has improved since the last inspection? What they could do better: To ensure that an identified resident is well cared for a care plan must be in place for the clinical condition identified. Furthermore, all accidents must be reviewed and risk assessment must be undertaken on the identified area of the home following an accident to a resident. In order to comply with the legislation staff records must be made available at the home for inspection. Also identified staff members must be regularly supervised to enable them to discuss areas of concern in relation to residents care. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 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. 46 Bath Road DS0000003384.V299720.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 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are assessed before admission to the home. EVIDENCE: The home remains committed to providing a high quality service for the residents. No resident is admitted to the home without full assessment from the Care Management Team of the South Gloucesteshire Council to ensure that their needs are met. Evidence from the care file of the most recent admission showed pre admission assessment from the Community Care Department of the council. The resident was unable to discuss the admission however responded in the affirmative when asked if they were happy at the home. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to participate in the decision making process of the home and are provided with individualised care plans that meet their needs. EVIDENCE: Two care files were viewed and both contain, personal profiles, individualised careplans, general records and daily statements of care given. The records were clear and the daily records were up to date. There was evidence that the care plans were regularly reviewed and action was being taken to reflect the changing needs of the residents. However it was noted that whilst the home monitor the weight of a resident who suffered weight loss, there was no care plan to inform staff of the residents need and what to do if the condition worsens. This was discused with the manager and a requirement was made to remedy the situation. Residents are encouraged to make choices in relation to what they eat, where they go and the time they go to bed. One resident spoken with on the day 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 10 stated that they participate in planning the menu and I went Bowling the other day with a staff member and a friend. In relation to managing their finances, the resident stated that they give me some money and I look after it myself. They keep the rest for me. Care files reviewed showed that the residents have been risk assessed in detail to enable the home to determine favourable activities for the residents without compromising their independence. Staff were aware of the importance of ensuring that information about the resident is kept confidential. It was noted that care files and other residents informaton were securely locked away. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to engage in leisure activities. Healthy diet is provided their rights are respected. EVIDENCE: Residents are assessed on their level of ability and motivation and are encouraged to participate in activities in and out of the home. Evidence from the care file and discussion from the manager showed that two residents have activities with staff at the home to incude visits to their parents, shopping, jigsaws, building blocks and spending quality time with the residents to build solid relationships. One resident visits Dovercourt Road Day Center five days a week and is visited by the parents every weekend. A suitable hoilday is being arranged. Another resident attends various activities in the comminity most days of the week to include, hydrotherapy, aromatherapy, monthly craft in church and also Sunday 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 12 srevice. the resident is a member of the Mothers Union and enjoys the Saturday breakfast cooking in church every Saturday. On the day of inspection one resident was seen getting ready to be taken out for shopping by a volunteer who had been helping out at the home since its inception. The volunteer stated that they enjoy taking the resident out every Friday for shopping and to service on Sundays. The volunteers also stated that the local church is very involved in the homes activities for the residents, According to the persons observation, the residents quality of life is far beyond how they were when they first arrived here. The Community Services Manager of Aspect and Milestone was visiting the home on the day of inspection. The visit was to meet the the volunteer and one of the residents in relation to a volunteer scheme set up by the organisation. The aim was to find out if the person enjoyed what they were doing, encourage and support them and to make them aware that the organisation recognises their invaluable contribution to the care of the residents that they work with. Pictures of the resident and the vulounteer were taken with their consent to enable the organisation to market the scheme. The project manager stated that it is expected that this would attract other volounteers to work with the residents. Two other residents were noted going out for various activities on the day. Staff were observed interacting with the residents in an informal and resoectful manner In relation to meals, one resident interviewed stated that they participate in planning their menu. The lunch on the day looked nutuitious and balanced, residents spoken with stated that they enjoyed their meal. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive prefered personal care. Medication practices are adequate EVIDENCE: Staff were noted interacting with residents in a respecful and digified manner. During the inspection staff were noted knocking on the door before going into a resident to assist the individual with personal care. One resident spoken with stated staff respect us and knock on our door when we are washing and dressing One recently appointed staff member spoken with was able to outline the support given to encourage the residents to maintain their independence and take control over their lives as much as practicably possible. Minor errors were noted on the Medication Administration Record Sheet. These were remeded before the inspection was concluded. Evidence of support from the General Practitioner (GP) and visits from other health professionals were noted in the care files reviewed. Positive comments about the home and the services to the residents were from one of the GP practices. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 14 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled to complain and are protected from abuse through appropriate systems. EVIDENCE: The home has a complaint procedure, a complaints book and meaningful information in picture format for residents explaining how to make a complaint. One staff member spoken with stated that some residents who are unable to communicate verbally show dissatifacton through their facial expression and body language and staff will use their experience of the resident to find out the problem and report it. Staff have attended training on the Protection of Vulnerable Adults from Abuse. Policies and Procedure are in place to report actual or suspected abuse. One member of staff is presently on Garden Leave for unacceptable attitude and using unsatisfactory language on a resident. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The environment is clean and well maintained and offer protection to the residents. EVIDENCE: At the last inspection a requirement was made in relation to a broken radiator in the hall way, it was pleasing to note that this had been replaced. It was also noted during the tour of the premises that call bells had been installed in the residents rooms identified at the last inspection. The premises was noted to be homely, warm and tidy. The home was well maintained and and in good decorative order. The manager stated that the patio door had been re-inforced with additional bolts following an attempted break-in, to ensure safety. It was agreed that the manager forward an action plan on safe systems to be installed at the home as recommended by the Crime Prevention Officers during their visit. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 17 The home was found generally clean and free from unpleasant smells. One resident soken with stated that they like their room and that they felt safe at the home. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents are supported by a comptent staff team however identified staff members must be regularly supervised. EVIDENCE: Whilst the home has a robust recruitment policy and is a part of an organisation, it was disappointing to note that the record of a recently transferred staff member from a sister home was not available at the home for inspection. The organisations head office was contacted on the phone on the day to confirm that the required statutary documentation was obtained before this individual commenced employment. The home must ensure that all staff records must be available at the home for inspection. There was evidence that new staff have received induction training on commencement of employment. One newly appointed staff member stated that they have attended training on First Aid, Protection of Vulnerable Adults from Abuse, values and neglect and Manual Handling. The individual also stated that staff were lovely, friendly and that everybody worked as a team to support them. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 19 There was evidence that staff have attended training updates on food hygiene, medication fire prevention, manual handling and abuse. Staff records showed that staff have received supervision however, two staff members are yet to receive regular supervision. The manager must ensure that the identified staff members are regularly supervised. 46 Bath Road DS0000003384.V299720.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Residents enjoy a well run home, however it fails to protect the residents through lack of review of some accidents and risk assessment of an identified area of the home following a resident’s fall. EVIDENCE: Josie Bolt remains a competent manager of 46 Bath Road. Josie had completed NVQ level 4 in Care Management and this has enabled her to support her staff in providing quality care to the residents. The manager stated that the Line Manager supervises her monthly and that this gives them the opportunity to discuss issues of concern at the home. The manager plans to understudy the present line manager to give her the opportunity for training and development. 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 21 Staff members spoken with stated that the manager remains approachable and is committed to providing a homely and safe environment for the residents. Whilst some of the residents were unable to communicate verbally there was clear evidence that the relationship between the residents and between residents and staff is cordial. In relation to auditing the quality of its services the manager stated that the home receives letters from the families expressing satisfaction from the services provided at the home. One letter seen stated, I never knew that such a standard of care was achievable. The home is just that; a home with a mixture of dedication and joy. Another letter from a visitor stated staff are caring and dedicated. The atmosphere in the home is one of joy and happiness Social services reviews have been satisfactory and there have been regular monthly-visits by the provider in accordance with the legislation. The fire logbook was noted to be satisfactory and the maintenance book was up to date. Accidents to residents were recorded however one accident recorded on 27/02/06 was not reviewed following a fall and injury to a resident. Further more accidents recorded on 3/01/06, 15/03/06 showed no evidence of review. The home must ensure that accidents are reviewed to ensure that measures are in place to prevent further accidents. A requirement was made for the home to carry out a risk assessment to the lounge following a fall of a resident due to a trip over mobility equipment of a fellow resident. Other health and safety checks at the home are satisfactory 46 Bath Road DS0000003384.V299720.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 X 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 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 3 X 2 X 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 3 4 2 1 Standard YA36 YA42 YA34 YA6 Regulation 18 24 17 15 Requirement Ensure that identified staff receive regular supervision. Ensure that all accidents to residents are reviewed. Records of all staff must be stored at the home. Develop care plan to monitor a resident with weight loss. Timescale for action 30/06/06 31/05/06 30/06/06 31/05/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almonds bury South Glos BS32 4RG 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 46 Bath Road DS0000003384.V299720.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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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