Inspection on 27/09/05 for 46 London Road

This inspection was carried out on 27th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

46 London Road 18/12/06

46 London Road 13/03/06

46 London Road 01/10/04

46 London Road 07/05/04

Similar services:

7 Hyde Road

5 Seafield Road

Trevaylor Manor

12 Orchard Mews

Stallcombe House

Stepping Stones

Cornerstones

The Vicarage

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

CARE HOME ADULTS 18-65 46 London Road 46 London Road Gloucester Glos GL1 3NZ Lead Inspector Mr Peter Still Unannounced Inspection 27th September 2005 12:00 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 46 London Road Address 46 London Road Gloucester Glos GL1 3NZ 01452 380835 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) londonroad@tiscali.co.uk Milbury Care Services Limited To be Appointed Care Home 10 Category(ies) of Physical disability (10) registration, with number of places 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 01/10/04 Brief Description of the Service: 46 London Road is a purpose-built care home run by Milbury Care Services. It provides care and accommodation for people with acquired brain injuries. The home is located close to Gloucester city centre. Residents are accommodated in single rooms on the ground and first floor. All of the bedrooms have en-suite facilities and a kitchenette. Stairs or lift can access the first floor. The home is designed to be fully accessible to wheelchair users. The home provides a large lounge and dining area and an adjacent communal kitchen. On the first floor there is a large craft and activities room. Outside there is a patio and lawns with extensive usable space. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four and a half hours. Six staff were on duty at the beginning of the inspection, reducing to four in the afternoon. Three of the ten residents were spoken with, other residents being observed and some residents engaged in activity away from the home were not seen. The atmosphere in the home was friendly and relaxed and residents spoke highly of their care and the way they are involved in making choices, improving their quality of life. The inspector made a tour of the home and a number of records were inspected. The acting manager and staff were helpful on the day of inspection and provided necessary documentation. What the service does well: What has improved since the last inspection? There is now more focus on the individual needs of residents. Staffing levels are improved and there is a full staff team. Holidays are now organised, one resident has just returned from a one to one holiday and discussion is taking place about the possibility of a holiday abroad for next year. The office was observed to be well-organised and new documentation has been put in place. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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): 1,2 Resident’s, benefit from good admission and assessment practice that ensures that the home is able to meet their needs. EVIDENCE: A service user guide is provided, but the acting manager is not content with the content and is currently re writing it; the current guide was seen and is basic and needs to be individualized to 46 London Road. Care needs are well met through a full assessment process carried out before a resident decides to live at the home. Care plans are developed from this information. The assessment includes the elements listed in the standard. A comprehensive assessment was seen for 2 residents. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 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, 9 Resident’s health and social care needs are well met and promoted by good recording and planning arrangements. Residents are supported in increasing their independent lifestyle and risk assessments are well written. EVIDENCE: Two residents files were read, they were clear, provided personal detail and included: pen picture, care plan and support required, communication passport, rehabilitation and a social diary, craft/activity review and planner. A monthly resident questionnaire is completed, which includes goals and the care plans and documentation was seen to be up to date. The acting manager should be commended for enhancing this documentation to ensure they are more user friendly. Care plans are reviewed monthly by the key worker and resident and overseen by the acting manager. Risk assessments were well set out within the individual files, providing clarity of information for residents and staff and recording showed they were kept up to date. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14, 17 Social activities and meals are well managed, creative and provide daily variation and interest for people living in the home. Residents are fully involved in making decisions about activity and menus. EVIDENCE: A full and varied activity programme is provided and residents and 2 staff and 3 residents talked about enjoying the activity, which includes: The local collage, local church, going out for lunch and a recent evening meal at a pub, horse riding, rock climbing, and visits to a sensory room at Cheltenham. An activity board is in a prominent position and is kept up to date, though an update is needed since the Colleges have just returned. The home has a mini bus and a car and one resident said that being able to go out from the home is the most important part of their life. The menu was inspected and appeared to be satisfactory, however 2 residents said the food could be more varied and 1 said there is a shortage of imagination and another that it could be more adventurous. Evidence was seen that the menu is discussed and agreed by the residents themselves each Sunday, representing excellent practice. It will be necessary to find additional ways of ensuring all residents are really content with the group consultation 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 11 and the food they receive and advice from a dietician, may help residents. Even though it appears that this is a negative aspect, the acting manager and her staff team should be commended for their approach in ensuring consultation and choice. A member of staff said that alternative food is provided when requested and residents talked about helping to prepare meals. The proximity of the kitchen to the main living area promotes a homely environment for residents and those who are not able to be involved can still enjoy the atmosphere. One resident said “ I am involved in planning the menu every Sunday”. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 12 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, 20 Resident’s lifestyle preferences and medication needs are well met and protected by good consultation, and an organised and tidy administration system. EVIDENCE: Three residents spoke highly of the care provided by staff and 2 residents, who need significant support, were very clear that personal support is provided in a caring way and when needed. One resident said it is “a great team. You get choice in everything within reason. I have 2 key workers and they sort out things”. One resident said their personal needs were being catered for in a way that was better than expected and “I am always listened to”. One resident said that sometimes clothing is put into the wrong room. One resident said the medication is reviewed and there are no issues with it. Medication was observed being given to a resident in a gentle way, providing water and ensuring good time between each tablet being administered. There was no feeling of hurry. No residents administer their own medication and the records inspected were found to be up to date signed and recorded. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 13 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 Residents are confident that they are listened to and their requests actioned. The provision of further staff training, concerning the protection of vulnerable adults from abuse or neglect will help keep residents safe. EVIDENCE: The home has a complaints book and none were recorded. Two residents spoken with said they are listened to and action is taken to address issues. Another resident said I am always listened to, especially if I shout. This was said with a smile and it was clear that the resident would ensure their needs were met and felt confident in communicating needs to staff. One resident said I have no complaints. The acting manager said she is discussing staff training with the company trainer in relation to abuse, neglect, ‘whistle blowing’ and ‘no secrets’. This training will be valuable for the staff team. A member of staff knew to contact the Commission if there was a concern about the home and was aware of where to get the phone number. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 14 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, 25, 30 The standard of the environment within the home is mainly good and there was assurance that outstanding issues would be remedied. Resident’s rooms suit their needs and have been personalised. EVIDENCE: One resident said that the current arrangement is difficult for people who smoke and if the outside area, which they currently use, between the building were to be covered with transparant material, this would be much appreciated. Clearly if any such cover were considered, the responsible agencies would need to be contacted in advance. One requirement and 1 recommendation from the last inspection have not been responded to: To lower the upstairs bath in accordance with the Occupational Therapist’s recommendations; provide sluicing facilities. Agreement has been reached that both matters will be achieved by March 2006. Carpets requiring replacement will be fitted once remedial decoration has been completed during October 2005. It has also been agreed that new furniture will be provided to the communal area. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 15 At the last inspection the bathrooms were considered to be stark with their white tiling and whilst this has improved, the manager is not content and wishes to make further improvements. The home was clean and free from offensive odours. Resident’s bedrooms have been personalised and 3 residents said they were pleased with their rooms, including the space, specialised equipment, and ensuite facilities. The COSH room is of a good size, where cleaning materials and chemicals are kept. This room was very tidy and well organised, leading to safe practice. A resident said that the payphone was broken, which is a vital link, especially for residents who are not able to use another phone locally. The acting manager said that it was being dealt with. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 16 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): 32,34, 36 The numbers and skill mix of competent staff are sufficient to meet resident’s needs. This is reinforced by well-supported staff, providing an effective team and the inclusion of residents in the recruitment of the staff. EVIDENCE: Four staff hold NVQ level 2 certificates, 8 staff are starting this qualification at the end of October. Four other staff hold the NVQ level 3 qualification and the acting manager holds the RMA qualification. Staff should be commended for their efforts in gaining their qualifications. It is positive to record that the home is fully staffed and there has been no need for agency staff for 3 months. In May and June, 3 residents were involved in the selection of their new staff and the home should be highly praised for this important inclusion. One member of staff said they enjoy supervision and it takes place every month and at other times when requested. Another member of staff said the ‘door is always open’, referring to the acting manager. Two residents gave particularly high praise for the way staff provide care to meet their needs. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 17 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 18 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 The lack of a registered manager working at the home, is to be addressed. The manager designate was seen to be effective in the role, providing good leadership and management. EVIDENCE: The registered manager visits the home once a week, providing good support to the acting manager who was observed to be very effective. Two staff and 2 residents spoken with supported this. It is anticipated that the acting manager will be interviewed by the Commission soon to consider her suitability to become the registered manager of the home. The acting manager has taken a number of positive steps to improve documentation and information systems at the home and the organisation of the office and files was observed to be very good and enabled easy access to records which is important for busy staff. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 19 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 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 X X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 4 X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 4 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X 4 X 4 CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 46 London Road Score 4 X 3 x Standard No 37 38 39 40 41 42 43 Score 2 X X X X X x DS0000016343.V249972.R01.S.doc Version 5.0 Page 20 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 YA30 Regulation 23 Requirement Provide sluicing facilities. (Previous timescale of 31/12/04 not met) Timescale for action 31/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA17 YA1 Good Practice Recommendations The acting manager should work with residents and staff to find extra ways to ensure all residents are content with their food and input from a dietician may help. The acting manager should be supported to produce the update to the service user guide she has identified as needing attention. 46 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 London Road DS0000016343.V249972.R01.S.doc Version 5.0 Page 22 - 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!