Inspection on 26/04/05 for 46 Grenville Road

This inspection was carried out on 26th April 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

46 Grenville Road 13/02/07

46 Grenville Road 14/11/05

46 Grenville Road 28/11/04

46 Grenville Road 27/07/04

46 Grenville Road 28/01/04

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 Grenville Road 46 Grenville Road St Judes Plymouth PL4 9PY Lead Inspector Antonia Reynolds Announced 26/04/05 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. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service 46 Grenville Road Address 46 Grenville Road, St Judes, Plymouth, Devon, PL4 9PY 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) 01752 310531 Michael Batt Foundation (Valued Life Projects) Mrs Paula Bryant Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: Learning disabled adults some of whom may have a mental disorder Age 18-65 years One named service user under the category of physical disability. Date of last inspection 28th November 2004 Brief Description of the Service: 46 Grenville Road is a care home providing personal care and accommodation for three people, aged 18 - 65, with learning disabilities, who may also have associated challenging behaviour and mental health issues. It is owned by the Michael Batt Foundation (Valued Life Projects) which is a not for profit organisation providing services for people with a range of needs who require support and care to live in the community. The home was purchased by the present owners in October 2003 and is a midterraced property located in the residential area of St Judes in Plymouth. It is close to Plymouth City Centre and all local amenities. All the homes bedrooms are single and are on the 1st floor. None of these have en suite facilities. There is a bathroom and a shower room on the 1st floor, both of which contain toilets. There is a lounge room, an activities room and a kitchen/diner on the ground floor and a small back yard. A stair lift provides access to the upper floor therefore all areas are accessible to the service users. Parking is available in the street. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 9.30am and 1.15pm. The Registered Manager, Paula Bryant and the Team Leader, Robin Vacquier were present. A tour of the premises took place and records relating to care, the staff and the home were inspected. Two of the three service users, a visiting relative, as well as two of the three staff on duty were spoken with and observed during the day. What the service does well: What has improved since the last inspection? What they could do better: The Registered Provider has not yet provided a statement of terms and conditions of residency for service users, and this was discussed during the inspection. Redecoration and refurbishment is ongoing and the Registered Provider has been asked to consider more suitable locks for bedroom and bathroom/toilet doors as part of this maintenance programme. Consideration 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 6 should also be given to undertake risk assessments for safe working practice topics. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2, 3, 4 and 5 Service users and prospective service users are not provided with adequate information as they do not have a statement of terms and conditions. Prospective service users are given opportunities to visit the home to decide whether they would like to live there and to meet the other service users and staff. EVIDENCE: The statement of purpose and Service User guide were available in the home. The guide has been produced in the form of individual leaflets with photographs and symbols, reflecting what is important to each service user. No new service users have been admitted to the home for a few years, however the management team confirmed that any prospective service users would be assessed prior to admission and a detailed assessment tool has been devised. As much information as possible is obtained from the service user, relatives and representatives, as well as other professionals involved in the person’s care and this is documented. Introductory visits are arranged for prospective and existing service users to meet each other and become familiar with the home prior to admission. Individual records are kept for each of the service users and these contained assessments, care plans, risk assessments and behavioural guidelines, all of which had been recently reviewed. Ongoing evaluation is recorded daily. Contracts with purchasing authorities are kept in the organisation’s head office, and files inspected contained copies of these. However, statements of terms 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 9 and conditions relating to residency in the home have not been produced for each service user. General information is provided in the booklet “Information for people” provided by the Michael Batt Foundation. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 10 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, 7, 8 and 9 The service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user has a care plan, risk assessments and behavioural guidelines that are regularly reviewed. The staff were fully aware of the needs of each resident. Any restrictions on choice or freedom were documented and had been agreed with the service user and other people involved in the person’s care. Observation showed that service users were aware of why these agreements were in place. The attitude and approach of the staff team promotes independence and is supported by the use of total communication skills. Records relating to service users’ money were up to date and accurate. From these it was evident that service users were expected to pay for personal items, as well as making a contribution towards the cost of transport. The organisation provides additional money for clothing and leisure activities. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 Service users can learn life skills, attend work placements, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Information in care plans, as well as talking with service users and relatives, showed that they were enabled to live as full a life as they wished to and had opportunities for personal development. Service users were encouraged to participate in all the domestic activities in the home and to take part in leisure activities of their choice. The Registered Manager confirmed that holidays were being planned for each service user with the cost being shared by the service user and the organisation. None of the service users had paid or voluntary employment, but educational and day service opportunities were available outside the home. The home did not provide transport as service users are encouraged to use public transport wherever possible. However, occasionally staff cars are used, for which service users are expected to make a contribution towards the cost of petrol. It was evident, through observation during the inspection, that service users 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 12 felt very ‘at home’ and were empowered to make decisions. Service users confirmed that they could make their own meals, drinks and snacks and chose the menu. Records were kept of meals provided. Discussion with service users and relatives confirmed that contact with relatives and friends was encouraged and there were no limitations in place regarding visitors to the home. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 standard(s) 18, 19 and 20 Service users receive support in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provided information about personal, emotional and health care needs. Information contained within service users’ files, as well as discussion with the Registered Manager confirmed that external professional advice and guidance was sought when necessary from local health care professionals or social services. Through observation it was clear that timings were flexible and the choice of the service user. A monitored dosage system was being used, regular medication reviews took place and risk assessments had been carried out regarding whether or not service users were able to keep their own medication, the result being that no-one self-administered medication. Medication was locked away safely and records pertaining to its administration were up to date and accurate. Where possible, service users signed to say they had taken their medication. A discussion took place about expanding the organisation’s medicines policy to include the ethos of the home. Advice was given to refer to the Royal Pharmaceutical Society’s guidance on the administration of medicines in care homes. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 14 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 standard(s) 22 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that the Registered Provider always deals with complaints seriously and any concerns from service users are listened to and acted upon immediately. EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints regarding the service since the last inspection. The home has a complaints procedure and the service users and relatives explained how they would make a complaint and who they would talk to. Regular house meetings were held where any issues could be raised and dealt with immediately, although it was also clear from discussion that service users could raise any issue at any time. Training in adult protection had taken place on 25th April 2005, therefore the management and staff team were well aware of adult protection issues and procedures were available. Each service user received the personal allowance element of income support each week, from the organisation’s head office, to spend as they wished. The mobility component of Disability Living Allowance was kept in the home and used for transport costs as required by the service users. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 standard(s) 24, 25, 26, 27, 28, 29 and 30 The home has recently been refurbished and redecorated in places, which is a significant improvement. It is comfortable, safe and clean. Bathroom and toilet facilities were adequate for the present service users. Service users are ‘at home’ in the environment and clearly feel they belong. EVIDENCE: Each service user has a single bedroom on the 1st floor, none of which had en suite facilities, and only one contained a wash hand basin. Bedrooms were individually furnished and contained many personal possessions. One of the bedrooms had a sensor device fitted to the door, which was only activated at night. Bedroom doors did not have appropriate locks because they could be opened by anyone. One of the service users keeps the bedroom door locked for security, therefore the type of lock used should be reconsidered to ensure privacy and security. Service users confirmed that they had chosen the décor and furnishings for their bedrooms. One bedroom is awaiting redecoration and a discussion took place with the Registered Manager about different ways of enabling the service user to participate in choosing the colour scheme. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 17 The home had a bathroom on the 1st floor consisting of a bath with a hoist, and a toilet. There was also a separate shower room with a toilet, which contained a rusty towel rail. The Registered Manager confirmed that this would be removed. There were small bolts on the doors to afford sufficient privacy and the Registered Manager confirmed that these could easily be forced if staff needed to gain access in an emergency. However, the Registered Provider should consider more appropriate locks as part of the overall improvement programme. There were shared rooms on the ground floor consisting of a kitchen/diner, a lounge room and an activities room, that was also used as a sleeping in room for staff. There was a built in refrigerator in the kitchen which was not working, but the Registered Manager said this would be addressed. The home has a ‘no smoking’ policy. Infection control practices were satisfactory and items of personal protective equipment, such as disposable gloves, were available. Laundry facilities were located in a shed in the back yard and guidelines were available on the disposal of clinical waste. The home has various aids and adaptations including a stair lift, bath hoist, and toilet frame. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well supported and supervised staff. EVIDENCE: Staff files inspected showed that the organisation has a robust recruitment procedure and all the required information was available. Criminal Record Bureau checks had been carried out but were kept in the organisation’s head office. All staff were provided with contracts of employment and job descriptions. Regular staff meetings and individual supervision sessions took place and were documented. The organisation has a designated staff member to coordinate and arrange training to maintain an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. The Registered Manager confirmed that staff were expected to attend relevant training on topics such as social role valorisation, person centred planning, human development, epilepsy, adult protection and breakaway techniques. The organisation does not tend to enrol staff on National Vocational Qualifications but have devised their own training, in consultation with the local College of Further Education, as this reflects the needs of the service users they support. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 19 Staffing rotas were available in the home showing that there were always two or three staff on duty, with two staff sleeping in at night. The Registered Manager confirmed that she was in the process of putting together a board with staff photographs, showing who would be on duty on any one day, as a communication aid for service users. Sleeping accommodation for staff was in the activities room and the lounge room. The Registered Manager confirmed that there are times when she is part of the staff rota, but there are times when she is on duty in addition to the support staff. The organisation operates an ‘on call’ system whereby members of the management team are available both in and out of office hours. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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 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, 38, 39, 40, 41 and 42 The management approach is open, inclusive and positive, providing clear leadership and guidance. Empowerment and enablement of service users is the focus of the organisation. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has been in post for approximately eighteen months and is undertaking a level 4 National Vocational Qualification. On completion of this, she intends to undertake the Registered Manager’s Award. The members of management and staff who were spoken with confirmed that they are consulted and included in any decisions regarding the running of the home. All documentation relating to service users was up to date and accurate. Records relating to health and safety issues, such as risk assessments, hazardous substances, the accident book, fire log book, employers liability insurance certificate and gas safety checks were available and up to date. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 21 All staff complete training in emergency first aid and the Registered Manager confirmed that health and safety, manual handling and food hygiene training, has been or is being arranged. The Registered Manager said that fire safety awareness training is covered during supervision sessions and confirmed that all staff are up to date. The use of hot water has been risk assessed and, as none of the hot water is regulated, the staff check the temperature of the water using a bath thermometer. A discussion took place about the benefits of documenting risk assessments relating to safe working practice topics. Records were kept of the temperature of the refrigerators/freezers but there was no hot food probe available. Advice was given to risk assess and provide one if necessary. Documentation was available confirming that health and safety checks, including checking portable electrical appliances, had been carried out by the Registered Manager on a six monthly basis and this was checked by the person responsible for carrying out the monthly provider visits. The organisation has devised a quality assurance system which will be implemented in due course. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 46 Grenville Road Score Standard No Score Version 1.20 Page 22 D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc 1 2 3 4 5 3 3 3 x 2 22 23 ENVIRONMENT 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 2 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 x 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 23 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. 1. Standard 5 Regulation 5 Requirement A statement of the terms and conditions/contract agreed between the service provider and the service users must be provided. (Timescale extended. This requirement has been unmet since 2003). Timescale for action 26 October 2005 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 26 Good Practice Recommendations Alternative locking devices should be fitted to bedroom doors to ensure privacy and security, whilst being accessible by staff from the outside in an emergency. 46 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 Page 24 Commission for Social Care Inspection Unit D1 Linhay Business Park Ashburton TQ13 7UP 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 Grenville Road D52-D04 S49889 46 Grenville Road V210944 260405 Stage 4.doc Version 1.20 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!