Inspection on 09/05/05 for 46a Court Road

This inspection was carried out on 9th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

46a Court Road 26/08/08

46a Court Road 01/09/07

46a Court Road 26/09/06

46a Court Road 07/01/06

46a Court Road 22/02/05

46a Court Road 22/07/04

46a Court Road 05/02/04

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 46a Court Road Kingswood South Glos BS15 9QG Lead Inspector Jackie Hargreaves Unannounced 9 May 2005 09:30 th 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. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 46a Court Road Address Kingswood South Glos BS15 9QG 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) 0117 909 5459 0117 970 9301 Aspects & Milestones Trust Christopher Gerald Horgan Care home for Younger Adults 5 Category(ies) of LD Learning disability registration, with number LD(E) Learning dis - over 65 of places for 5 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Not applicable Date of last inspection 22/02/05 Announced Brief Description of the Service: 46a Court Road is one of a number of homes operated by Aspects and Milestones Trust. The home is registered to provide accommodation and personal care to five service users with learning disabilities. The current service users are all over the age of 65 years.The property is situated in Kingswood, five miles from the centre of Bristol. Shops are a few minutes walk from the home. There are local bus services and the home also has its own minibus. Accommodation consists of a main house with four bedrooms. Two bedrooms are situated on the ground floor. There is a purpose built bungalow to the rear of the property that accommodates one service user who is supported to live semi-independently. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out in one day. The manager was not in the home. The inspector spoke with three staff members and three residents who were in the home throughout the inspection. What the service does well: What has improved since the last inspection? In the absence of the manager the inspector was unable to identify any significant improvements made since the previous inspection carried out in February 05, however, following a requirement made at the previous inspection the home has replaced the minibus with a new eight-seater vehicle. Health action plans had been fully implemented which provide a means to ensure that resident’s health checks and health needs are fully 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,3 The home’s admissions procedures ensure that a person is fully informed about the service and their needs are properly assessed prior to entering the home. EVIDENCE: There was detailed information available on the current services and facilities provided at the home and a pictorial guide that would enable a person with learning and reading difficulties to know about the home and what it had to offer. There had been no new admissions to the home for some years. However, admission, assessment and care planning formats held in the home and discussions with staff demonstrated that assessment processes were thorough and a person would not be introduced to the home without a professional assessment and consideration of their needs and wishes along with the home’s ability to meet their needs. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9,10 Residents were consulted about how their needs were to be met and were enabled to make daily living choices within the limits of personal safety. EVIDENCE: 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 10 The inspector examined care and life plans in respect of three residents. The language used and the content of the plans demonstrated that the residents had been involved in developing the plans. The help each person wanted or needed to enable them to meet their needs and make choices was written into the plans to guide staff. Plans were written in plain language although were not in visual or graphic form for residents who could not read and this should be considered. Actions taken to meet resident’s needs were signed and dated to demonstrate how they were met. Things that were essential or important to each resident were also clearly written to direct staff. Diary events had been reviewed with residents on a monthly basis, which enabled each person to discuss whether or not they were happy with life in the home and with their routines/activities and to make changes. This is commendable. A resident confirmed they chose how help was provided and their activities. The inspector observed that this person held and controlled their personal money for these activities. The inspector checked the system for holding, distributing and recording residents daily finances and it was found to be satisfactory. To ensure resident’s safety, risks arising out of care/life planning such as risks associated with bathing, kitchen tasks, money, taking medication, road safety and behaviour had been assessed and included actions to minimise the risks. Risk assessments were signed by staff to demonstrate they had read them. Resident’s care records and other records were held in a domestic style cabinet that did not lock. To ensure confidentiality they should be made secure. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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 The service provides opportunities to enable resident’s to know their local community, mix socially and learn new skills. EVIDENCE: Discussions with residents about daily routines and observations in the home evidenced that resident’s independence was promoted. One resident was supported to maintain his independence by being accommodated in a wellequipped bungalow situated in the grounds of the main house. Residents were enabled to do ordinary everyday things outside the home and to be included in their local community through going to local shops, Church, a local pensioners club and social club. Other daily activities included education or work-oriented activities such as attendance at college and supported farm work or services specialising in supporting people with learning disabilities. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 12 Staff and residents reported good relationships with neighbours. To ensure residents were transported safely a new eight-seated vehicle was being delivered to replace the old minibus. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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 There is assessment and monitoring of resident’s health needs were assessed and monitored however this needs to be reviewed in the case of one resident to ensure the person’s needs are fully met. EVIDENCE: Resident’s health and medical records viewed were in order and demonstrated that health needs were acted upon and appropriately dealt with. Health action plans were being completed for each resident in line with Department of Health guidelines. There was a detailed care plan approach specifically regarding how staff should support a resident with needs relating to ageing. The inspector saw that these needs had been discussed at a team meeting to ensure the best care approach. The person’s needs had been reviewed with input from specialist health services to ensure the resident’s health needs could be met in the home. However, daily records indicated that in order to implement the care plan effectively additional resources could be required. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 14 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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) 22,23 Residents are encouraged to state their views and measures are in place to ensure suspicion or allegation of abuse would be appropriately responded to. EVIDENCE: No complaints had been recorded in the home during the past year or since the previous inspection. Each resident had been supplied with a complaints form in graphic format where a complaint could be noted and registered. Discussions with a resident and staff about how the service responds to things a person may be unhappy with confirmed that residents were listened to and staff would speak with residents to resolve dissatisfactions or disputes. If not resolved or repeated the complaints procedure would be used. The inspector observed open relationships between residents and staff. Residents were asked how they wanted things to be done, and showed confidence in stating their opinions and requests. There were policies and guidelines on the protection of residents from abuse that had been signed by staff to indicate they had read them. There had been progress in providing staff training on the protection of vulnerable adults from abuse. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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) 24,25,26,27,28,29,30 Although limited improvements to the environment had been made, new and outstanding matters did not ensure residents were living in comfortable, hygienic and safe surroundings. EVIDENCE: There had been re-occurring problems with the heating system. On the day of the inspection the heating system had not been working properly for several days and there had been no constant hot water during this time. An engineer visited the home on the day of the inspection but the problem was not resolved. This was not a new occurrence and places people at risk. There were patches of metal exposed on the base of the bath, on the underside of the hoist used for bathing residents and on the hoist’s pedestal base, which places residents at risk of infection. The inspector contacted the manager following the inspection and was advised that that this was now being addressed. The upstairs bathroom radiator was rusted. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 17 Daily records had noted that handrails in the shower were now ‘useless’ for one resident. This had been put into the maintenance book but had not been addressed and did not ensure the person’s safety when showering. There was an odour in the home despite staff attempts to clean floors and carpets. The carpet cleaner was of a domestic type and insufficient to ensure satisfactory standards of cleanliness and hygiene for residents. Bathroom and toilet flooring looked unhygienic although staff were doing their best to keep them clean. One resident’s needs had increased significantly. Examination of daily records and discussions with staff indicated the need to re-assess for additional aids and adaptations in order to effectively meet the person’s needs. One bed mattress had ridges and the resident indicated discomfort to her back. This was reported to the manager. The TV picture indicated a problem with the reception ariel which should be addressed to see if it can be improved for the benefit of residents. The garden had overrun with weeds and was not well maintained for residents to use and enjoy. Redecoration to the lounge was an outstanding matter and improvements could be made to the conservatory to provide a more pleasant sitting area for residents. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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) 32,33 The home had a stable qualified staff team that provided consistency of support and were experienced in meeting the needs of the residents however there is not always sufficient staff in the home at all times to ensure the welfare and safety of residents. EVIDENCE: Examination of the staffing rota for June 05 showed a minimum of two staff on some shifts in the main house. However, the inspector saw a directive that stated under certain circumstances staff would be expected to work on their own where a member of staff did not report for work. This was expected to be a rare occurrence and staff working in the supported living bungalow could provide back up. The inspector understood that this was a consequence of a staffing overspend. However, on examination of staff handover records the inspector was concerned that on occasions staff had worked alone for periods of up to three hours and one evening for four hours with no back up which placed residents and staff at risk. This practice was later discussed with the manager who advised the inspector that the normal rota was being reinstated. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 19 One resident’s needs have increased. Examination of daily records and discussions with staff highlighted difficulties in meeting this resident’s needs at all times in and out of the home. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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) 37,38,39,42 The home’s manager is resident focussed and has implemented systems that demonstrate a commitment by the staff team to ensuring residents receive good quality care and their health, safety and welfare is promoted. EVIDENCE: The registered manager is well qualified and experienced and manages the home with the interests of residents uppermost through the Trust’s lines of accountability. There were systems in place to demonstrate consultation with residents and staff in providing and developing the services for the benefit of residents such as monthly meetings, house meetings, staff supervision and a business plan that included input from residents and staff. A selection of records examined by the inspector confirmed that the health and safety of residents was promoted. Accident forms were appropriately completed; there was an up to date electrical installation certificate; the 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 21 testing of all equipment in the home was carried out in November 04; there was a satisfactory gas safety record dated March 05; manual handling risk assessments had been reviewed in December 05; Control of substances hazardous to health risk assessments were reviewed in January 05. There was an up to date monthly health and safety checklist for the whole house. A staff member advised the inspector that anything found went into the maintenance book. The fire logbook was up to date. Smoke detectors call points and break glass points were tested in April 05. Annual fire safety training took place in December 04 and video training was held in February 05. 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 N/A N/A Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 2 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 3 2 1 2 2 2 Standard No 11 12 13 14 15 16 17 N/A 3 3 N/A N/A N/A N/A Standard No 31 32 33 34 35 36 Score N/A 3 1 N/A N/A N/A CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 46a Court Road Score N/A 3 N/A 2 Standard No 37 38 39 40 41 42 43 Score 3 3 N/A N/A N/A 3 N/A Version 1.30 Page 23 D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc 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. 2. Standard 10 21 Regulation 17(1)(b) 23(2)(n) Requirement Ensure residents records are held securely Ensure that suitable euipment adaptations and support are provided to meet the needs of the elderly resident whose health and physical needs have significantly increased Keep the home free from offensive odours and ensure the lounge carpet and bathroom floor coverings are clean and hygienic. Ensure the grounds and garden are approprately maintained The service must ensure that the heating boiler is fully repaired or replaced Repair or replace the downstairs bath within the extended timescale granted at this inspection. Repair or replace the bath hoist within the extended timescale granted at this inspection. Repair or replace the bathroom radiator. Ensure that sufficient numbers of staff are working in the home at all times to ensure the welfare and safety of residents. Version 1.30 Timescale for action 01.07.05 01.08.05 3. 24 16(2)(k) 01.08.05 4. 5. 6. 28 24 27 23(2)(o) 23(2)(p) 23(2)(c) 01.08.05 09.05.05 30.08.05 7. 8. 9. 27 27 33 23(2)(c) 23(2)(c) 18(a) 30.08.05 30.08.05 30.05.05 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Page 24 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 28 24 Good Practice Recommendations The lounge should be redecorated The TV reception ariel should be checked 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 25 Commission for Social Care Inspection 300 Aztec West Almondsbury 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 46a Court Road D56_D05_S3380_46aCourtRoad_V223922_090505_Stage 4.doc Version 1.30 Page 26 - 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. 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