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Inspection on 07/01/06 for 48 Burton Road

Also see our care home review for 48 Burton Road for more information

This inspection was carried out on 7th January 2006.

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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The service provides a good standard of environment, which was well maintained and decorated A full staff team had been recruited providing adequate staffing levels to meet the needs of service users. The procedures for the administration of medication were satisfactory and the personal and health care needs of service users were appropriately met. Care plans were reflective of the assessed needs of service users and there was evidence that service users were involved in the care planning process.

What has improved since the last inspection?

All requirements of the last inspection had been met within the timescales agreed. A full staff team was in place. New furniture and some redecoration of the home had occurred since the last inspection.

What the care home could do better:

Ensure that all staff were involved in a least two fire drills per year. Ensure that risk assessments that were in place to safe guard service users, are implemented. Liaise with the fire safety officer re any changes to fire safety risk assessments. Ensure that 50% of the care team are trained to at least NVQ level 2 in care. Provide staff with training in the new format of Person Centred Planning.

CARE HOME ADULTS 18-65 48 Burton Road, Branston Burton On Trent Staffordshire DE14 3DN Lead Inspector Ms Wendy Jones Unannounced Inspection 7 January 2006 14:30 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 48 Burton Road, Address Branston Burton On Trent Staffordshire DE14 3DN 01283 535366 01283 545370 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) Robinia Care Homes (2) Limited Denise Jane Flannagan Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th June 2005 Brief Description of the Service: The service is registered to provide 24-hour support and care for four younger adults with a learning disability. The property is a period semi-detached house located in the residential area of Branston, on the outskirts of Burton-on-Trent. The home is conveniently situated close to a town, on a bus route and close to shops and amenities. The premises are set back from the main road and have tall metal gates leading to the gravel frontage and drive. The building is on three floors and comprises: four bedrooms, an office/sleep-in room, lounge, dining/activity room, bathroom and toilet facilities, laundry room and additional storage. One of the bedrooms has an en-suite shower and toilet facility. Parking space is adequate and to the rear of the house is a large garden and patio area. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out on 7th January 2006. The inspection methodology included discussion with care staff, interview of one staff, conversation one service user; observation of interactions between service users and staff; from information provided in the care records, staff rotas, risk assessments, policies and procedures; from inspection of the environment. The service is registered to provide 24-hour care for service users under 65 years who have a Learning Disability. At the time of inspection three service users occupied the home. All were reported to have severe learning disabilities, Autism Spectrum Disorders or communication difficulties and could display some behaviours that challenged the service. What the service does well: What has improved since the last inspection? All requirements of the last inspection had been met within the timescales agreed. A full staff team was in place. New furniture and some redecoration of the home had occurred since the last inspection. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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): EVIDENCE: These standards were not inspected during this visit. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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): 6,10. There was a clear care planning system in place to provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: A sample of care records showed that care plans were in place and had been subject to review. Where possible service users were involved with them. 24hour plans of care provided a pen picture of the preferred routines of individuals and the assistance they required. The service is to introduce a new person-centred planning format. Staff have yet to receive training in its implementation. Risk assessments were in place for individuals and most had been subject to regular review. However, in one example it appeared that a risk assessment had not been reviewed since April 2004. Service users’ care records were appropriately stored in a locked office environment. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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): 14,15. Service users were provided with opportunities to engage in meaningful activities. EVIDENCE: There was evidence that service users were supported to maintain contact with relatives from the records of telephone calls and correspondence. Records showed that service users engaged in a number of activities in and out of the home. Outings have been arranged based upon the known interests of service users and holidays were being planned for the coming year. Most activities were of a social, leisure or recreational nature - the staff identified that suitable occupational and educational opportunities were difficult to find. Advice was given regarding alternative activities and holidays. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 11 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 The medication at this home is well managed promoting good health. The staff had a very good understanding of the service users’ support needs and this is evident from the positive relationships which have been formed between the staff and service users. The health needs of service users are well met with evidence of good multidisciplinary working taking place on a regular basis. EVIDENCE: The personal and healthcare needs of service users were satisfactorily met. Staff were observed to interact appropriately with service users and there was evidence of rapport and good relationships. Staff were allocated and personal carers or key workers to service users working in teams to offer individual support. There was evidence of team discussions and reviews of service user progress and development from the records seen. Challenging behaviour of service users was continually reviewed. Staff had received training in the behavioural management strategies. One care worker described diversional type techniques as an effective method of de-escalating behaviour, staff had also received training in breakaway techniques. Care staff 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 12 confirmed that debriefing was provided after any episode of challenging behaviour. There was evidence in the records seen and from discussion with staff that the needs of service users were known and understood, there was evidence that health services were accessed. Including regular checks and reviews at the GP’s and input from specialist health services to monitor and review medication, and specific health conditions. Community based services such as dental and chiropody were also accessed with staff support. Speech Therapy and psychology input was also received. Staff were to receive training in Makaton, a form of sign language used by service users. Medication records were appropriately maintained with evidence that medication was signed for at the time of administration. Protocols were in place for the safe administration of as required medication. A record of medication received in the home and returned to the pharmacy was available for inspection. Storage of medication was appropriate; staff responsible for the administration of medication had received certificated medication training. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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): 23 Arrangements for protecting service users were satisfactory providing safety from a possible risk of harm or abuse. EVIDENCE: The staff were reported to have received training in recognising and reporting abuse. The service has policies and procedures in place for the protection of service users and whistle-blowing. No Vulnerable adults or complaints investigations have been convened relating to this service in the last twelve months. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 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, 30 The standard of the environment within this home is good providing service users with an attractive and homely place to live. EVIDENCE: This visit did not include a detailed inspection of the environment, but there was evidence of some refurbishment and redecoration, providing a pleasant and comfortable home. Accommodation was provided over three floors; a lounge, dining room, kitchen and toilet were located on the ground floor. The first floor had three bedrooms all with wash hand basins; a bathroom, laundry and a staff sleep in/office. The top floor had the largest of the four bedrooms. Throughout the home appeared to be clean and well maintained. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 15 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): 33, 35 Staff morale is high, resulting in an enthusiastic workforce that works positively with service users to improve their whole quality of life. EVIDENCE: Staffing for the day of the inspection included: 1x 7.30am-2.30pm, 1 x 7.30am-10pm, 1x 12.30pm-8pm, 1x 2.30pm-10pm (sleep over) 1x 10pm-8am No staff vacancies were reported. Staff training in NVQ included 3 staff undertaking level 2 training, 2 undertaking level 3, the service should continue with the programme of training to ensure that 50 of the care staff team have achieved a NVQ Level 2 qualification in care. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 16 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): 39, 42 The home regularly reviews aspects of its performance through a good programme of self-review and consultations, which include seeking the views of service users, staff and relatives. EVIDENCE: The service has undertaken quality audits and the organisation has produced an analysis of the outcomes including the comments and feedback from service users and families. The annual development plan for the service has yet to be produced, and a summary of the outcomes should be included in the Service User Guide. Fire safety checks were appropriately recorded. Records showed that fire drills had occurred in September and October 2005, with four staff participating in these. Requirements were made in relation to the number of drills staff must receive. Risk assessments were in place for individual service users and for more general risk. One risk assessment indicated that the garden gates must be 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 17 locked at all times to reduce the risk of accident; on this occasion one set of gates was open. It was confirmed with staff that the risk assessment continued to be relevant and action was taken during this visit to ensure that service users were not placed at unnecessary risk. It was recommended that the risk assessment was kept under constant review to ensure that service users rights are respected. It was also suggested that the manager reviews the fire safety risk assessment and consults with fire safety officers, regarding the safety measures taken. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 18 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 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X X X 3 X X 1 X 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard YA42 YA42 YA39 Regulation 23 13 24 Requirement Day staff must receive 2 fire drills per year, night staff must receive 4. Risk assessments must be followed. Evidence of a development plan must be provided. Timescale for action 07/04/06 07/01/06 14/09/05 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. 3. 4. Refer to Standard YA32 YA6 YA42 YA39 Good Practice Recommendations The service should ensure that 50 of the care team have an NVQ 2 qualification in care. The PCP model of care should be implemented. Records of the names of staff attending fire drills should be maintained. A summary of the outcomes of service user and families feedback should be included in the Service User Guide. 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 48 Burton Road, DS0000004923.V280805.R01.S.doc Version 5.1 Page 21 - 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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