Inspection on 31/05/06 for 48 Heath Road

This inspection was carried out on 31st May 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

48 Heath Road 29/05/07

48 Heath Road 10/11/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 48 Heath Road 48 Heath Road Holmewood Chesterfield Derbyshire S42 5SW Lead Inspector Vanessa Davies Unannounced Inspection 31st May 2006 09:30 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 48 Heath Road Address 48 Heath Road Holmewood Chesterfield Derbyshire S42 5SW 01246 857620 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) Milbury Miss Vanessa Blackburn Care Home 10 Category(ies) of Learning disability (10) registration, with number of places 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 10th November 2005 Brief Description of the Service: Heath Road is a large detached home with a number of communal lounges and a large dining room. Each bedroom has an en-suite facility and there is a bedroom provided for relatives who need to stay to due travel distance. There is ample off road parking and pleasant outdoor areas. Heath Road is home to service users with a learning disability. All service users have access to a range of professionals via a referral system. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This visit was unannounced, the manager was not available as she was on annual leave. Information for this report was gathered before the visit and during the visit. Information was gathered by reading records, speaking with staff, speaking with service users and observing staff working with the service users. What the service does well: What has improved since the last inspection? What they could do better: The manager should ensure that the assessment of need for all service users is fully complete. Each file had risk assessments and other information regarding the behaviours of the people concerned, however information was limited and therefore potentially prevents staff from meeting the service users needs. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 6 Adult protection issues must be reported to Social Services in accordance with their procedures. All staff must receive training relevant to the work they undertake. Staffing numbers must meet the needs of the service users, this was not evident on the day of the visit after viewing staffing levels and reading risk assessments and speaking with staff on duty. 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 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. Assessments completed prior to a move to the home and with input from the service users ensure that staff have enough information to meet their needs. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: Service users all have an assessment of need completed prior to any move to the home. Each file examined had an assessment of need, one being completed by a Community Nurse. There was limited information regarding health needs, within one file examined. It was evident that where possible service users and relatives are involved with the preparation and review of assessments. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. Involving service users with their care planning helps to give ownership, however staff not being aware of care plans and risk assessments not giving sufficient details potentially prevent needs for being met and can put staff and residents at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: It was evident within the file that the service users are as involved as possible with their care. One file examined had a detailed behaviour management plan in place, however it was evident that staff were not following this consistently and one member of staff spoken with was unsure about what the service users care files and care plans were, she was under the impression these were only accessible to the manager. One service user spoken with felt that he was assisted to make the decisions he wanted to make and that his independence was promoted, this was evident on the day of the visit. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 10 Within the two files examined there were risk assessments and other information regarding the behaviours of the people concerned, however one file detailed the risk but not how to manage it and had other very limited information about risk management and the other file had an out of date behaviour plan in place, the home has implemented a new one since the inspection visit and a copy has been provided. However one of the risk assessments stated that for a limited period because of safety issues there should be 2 waking night staff on duty and this had not been implemented. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. Staff offering choice and providing support as necessary ensures that the service users maintain and develop new living skills. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: Service users spoken with stated that they are supported and encouraged to participate in numerous appropriate activities. The inspector spoke with one service user who regularly attends a training centre to practice running, this is clearly a valuable activity to this person. Others attend colleges and arrange various activities with the help of the staff team. Service users spoken with stated that they visited the local pub and shopped locally too and this was evident on the day of the visit. The home caters well for maintaining contact with families as there is a specific bedroom provided for those having to travel long distances. Service users confirmed that they have regular contact with families and friends. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 12 Service users spoken with felt that the staff treated them with respect, although one service user had recently complained about how staff spoke to her and this was being investigated. The service users spoken with stated that they decide on a menu and then helped to prepare the food. Menus appeared to offer a healthy, varied diet. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. Positive relationships between staff and service users assists with development, however limited information relating to health needs potentially prevent staff from meeting the needs of the service users. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: It was evident on the day of the visit that staff have a very positive relationship with the service users. The service users spoken with stated that they are able to choose what they want to wear and are able to choose what time to go to bed and what time to get up in the morning; dependent on pre arranged activities or days at college. All personal support if given in private. Service users spoken with felt that supported them as necessary with medical appointments and referrals to relevant professionals. As stated earlier in this report there was limited information relating to the health needs of one of the service users files examined. It highlighted issues but not how to resolve them. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 14 Medication is stored in a lockable cabinet kept in the office. Medication is recorded appropriately and administered by suitably trained staff. The home keeps a record of medication received and administered. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. Listening to service users views and addressing any complaints ensures that the service develops to meet the service users needs. Lack of training in adult protection and restraint potentially puts service users and staff at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The service users spoken with did feel that staff listened to them and this was evident on the day of the visit. The staff record complaints made and these are addressed with appropriate responses. All service users spoken with were aware of who to complain to if they needed to. The organisation does have a detailed policy and procedure to address adult protection. Of the 3 staff members spoken with one stated that she had not had any training since starting in December. She did state that she had been involved with restraining service users and this was evident when reading incident records. One incident recorded detailed a potential adult protection issue, this was being investigated, however it had not been reported to adult protection team. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. A homely, comfortable environment assists service users to take pride in their home, improving morale and personal appearance. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: Heath Road has recently opened and prior to that completely refurbished. It is in a good state of repair and service users spoken with stated that any repairs are ‘fixed’ quickly. The home provides a safe, comfortable, large environment. The home is kept clean. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 17 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): 32,33,35 Quality in this outcome area is adequate. Lack of appropriate training for all staff and low staffing levels potentially puts service users and staff at risk of harm and limits the staff teams ability to meet the service users needs. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: The manager was not available on the day of inspection, therefore not all records were accessible. Records seen showed that the majority of staff had received First Aid training and Firs Safety training. As stated previously one member of staff stated that she had not received any training since starting with the organisation. On the day of the visit there were 7 service users and 7 members of staff, at some time during the visit 2 members of staff took a service user out leaving 6 service users and 5 staff. The rota seen over a 2 week period details 7 staff on the majority of the time, however there were 6 occasions when 6 staff were on duty, 1 occasion where 5 staff were on duty and 2 occasions where 8 staff were on duty. Information forwarded regarding hours for each service users states that additional hours should be in place for 2 service users, however this is not evident on the rota seen. A care plan for one service user states that she 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 18 should have additional staff for a specific period of time for the safety of the staff, however this was not evident on the rotas seen. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 19 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): 42 Quality in this outcome area is adequate. Limited information regarding risk assessments potentially puts service users and staff at risk. This outcome has been made from evidence gathered before and during the visit to the service. EVIDENCE: It was difficult to assess this section as the manager was on leave, it will therefore be assessed at a later date. As stated earlier in this report, risk assessments highlighted risks but not how to manage them. Risk assessments completed for one service user stated that two staff were needed to manage behaviours being presented, however this had not been implemented. 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 3 X X X X X X 2 X 48 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 21 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 Standard YA9 YA23 Regulation 13.4 (c) Requirement Timescale for action 15/07/06 31/07/06 3 4 YA33 YA32 Unnecessary risks to health and safety should be so far as possible be eliminated. 13.6 13.7, Appropriate training must be 18.1 c i provided for all staff to ensure that service users are not placed at risk. 18.1a Staffing levels should meet the needs of the service users. 18.1 c I Staff must receive training appropriate to the work they undertake. 30/06/06 31/07/06 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 3 Refer to Standard YA2 YA6 YA19 Good Practice Recommendations All service users should have as much detail as possible in their assessment of need. All staff should be aware of their role within the care planning process and implementation. Detailed information relating to the health needs and how to meet the needs should be available in all service users files. DS0000063006.V300145.R01.S.doc Version 5.2 Page 22 48 Heath Road Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT 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 Heath Road DS0000063006.V300145.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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