Inspection on 03/05/06 for 49 Stolford Rise

This inspection was carried out on 3rd 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

49 Stolford Rise 29/01/07

49 Stolford Rise 19/09/05

49 Stolford Rise 11/04/05

49 Stolford Rise 02/11/04

49 Stolford Rise 04/05/04

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

CARE HOME ADULTS 18-65 Stolford Rise (49) 49 Stolford Rise Tattenhoe Milton Keynes Bucks MK4 3DW Lead Inspector Nichola Cahill Unannounced Inspection 3rd May 2006 09:30 Stolford Rise (49) DS0000015082.V290326.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 Stolford Rise (49) DS0000015082.V290326.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. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Stolford Rise (49) Address 49 Stolford Rise Tattenhoe Milton Keynes Bucks MK4 3DW 01908 505626 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) The Disabilities Trust Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for three people with a learning disability. Date of last inspection 19th September 2005 Brief Description of the Service: Stolford Rise is a residential home providing care and support to three service users with a learning disability. The home is located in a residential area of Milton Keynes. It is close to local shops and is on a bus route to Milton Keynes where a wider range of activities and amenities are available. The home consists of a two-storey building. All of the bedrooms are single and each service user has a separate individual lounge area. At the rear of the property is an enclosed garden with seating. Service users are able to access the services of other health care professionals through their GP at the local surgery. Milton Keynes hospital is within a 5-mile radius of the home. The current fees range from £1200 per week to £1500 per week. Information regarding the services offered by the home are available within the statement of purpose, which is available on request. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the summary of the annual unannounced inspection visit carried out on 3rd May 2006 by Nicky Cahill and Gill Gentles. The inspection took a total of twelve hours, this included the pre-planning. The inspection consisted of discussions with service users, staff and the unit general manager, viewing documentation, staff questionnaires and service users written feedback. A tour of the home was carried out and health and safety documentation was viewed for some areas. All key standards were assessed and an assessment was made of compliance against requirements made at the previous inspection visit. The Commission would like to thank the service users and staff for their assistance during the inspection. A full discussion of findings from this visit were fed back to the unit general manager, Tony Rodriguez. What the service does well: Potential service users would receive a pre-admission assessment, ensuring that the home is the appropriate placement. Care plans are detailed and would ensure that service users needs are fully met. Service users are supported in making decisions regarding their lifestyle, which enables them to be involved in all aspects of their care. Continuing education and occupation is encouraged, as are community links and social inclusion. The home promotes service users choice and involvement in meals, providing them with a varied and balanced diet. Service users are supported to meet their personal care needs and to access specialist and healthcare services that meet their individual needs. Staff training is up to date in most areas, although only a small percentage have completed NVQ training in care. The home does not have a manager at present, however, service users benefit from a reasonably well run home. Health and safety systems protect the safety of service users. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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. Stolford Rise (49) DS0000015082.V290326.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 Stolford Rise (49) DS0000015082.V290326.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): 1, 2 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Information is available regarding the services offered, however, this is not instantly available to service users and does not allow them to always be fully informed. Potential service users would receive a pre-admission assessment, ensuring that the home is the appropriate placement. EVIDENCE: The home has a statement of purpose and service users guide. Both documents will need some small amendments regarding the current management details. Service users guides had been issued to the three service users; however, these were locked in care plan files in the office. Recommendations have been made for improvement in this area. The home has not admitted any new service users during the last two years. A pre-admission policy and procedure is available. It was confirmed by the unit general manager that this procedure would be used should any referrals be made. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 9 Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence during a visit to the service. Care plans are detailed and would ensure that service users needs are fully met. Service users are supported in making decisions regarding their lifestyle, which enables them to be involved in all aspects of their care. However, concerns regarding the relationships between service users would highlight that decisions around the choice of placement have not been fully supported. Risk assessments are in place, however, some specific areas have not been assessed and could, potentially, compromise service users safety. EVIDENCE: Two care plans were viewed at this inspection visit and discussed with service users and staff. Care plans were detailed and included a ‘pen picture’, information regarding daily living, specialist intervention, behaviour management plans, likes and dislikes and support needed. Further improvement could be made to identify the levels of support required in reaching personal goals, how they will be achieved and within what timescale. A recommendation for improvement has been made in this area. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 11 It was clear that service users are empowered in decisions regarding their choices and aspirations. However, there were some concerns noted regarding the compatibility of the service user group and the break down in relationships and how the staff team had addressed this. It was apparent through discussions and from documents viewed that their had been some conflict within the home and that service users were feeling unhappy regarding their placements. Concerns regarding issues noted were discussed during the inspection feedback with the unit general manager and a requirement has been made for improvement in this area. Personal risk assessments were in place and were detailed. It was confirmed by staff that risk assessments were in the process of being updated at the time of the visit, however, it was noted that some risks had not been identified. A recommendation for improvement has been made in this area. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 12 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 and 17 Quality in this outcome area is adequate. This judgement has been made using available evidence during a visit to the service. Continuing education and occupation is encouraged, as are community links and social inclusion. However, leisure activities do not appear to allow service users their personal choices at all times. The home promotes service users choice and involvement in meals, providing them with a varied and balanced diet. EVIDENCE: Activities were discussed with service users and staff and records were viewed. It was confirmed by staff, and from the staff rota, that three staff had been allocated to the morning shift in order to allow ‘activity’ time for service users. However, during the visit staff intervention with any such activities was minimal. Service users discussed that the activities planned were not always their choice and there was not enough variety, it was also suggested that the mornings were not always the ideal time for these. Recommendations have been made for improvement in this area. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 13 It was confirmed through discussions and from documents viewed that service users are fully supported in maintaining contact with family and friends and the local community. Visitors to the home are welcomed at any time. Service users are also fully supported in their cultural needs and choices. On the day of the inspection visit the local elections were taking place. Service users confirmed that they had been fully supported in ensuring that they could have their vote should they so wish. Service users are able to assist with the purchase of food and in the preparation. Meal times are relaxed and can be taken at leisure. However, encouragement is given for the evening meal to be eaten together as a social ‘get together’. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 14 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 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence during a visit to the service. Service users are supported to meet their personal care needs and to access specialist and healthcare services that meet their individual needs. Some small improvements need to be made to medication administration systems in order to ensure the safety of service users at all times. EVIDENCE: From discussions with service users and staff and from documentation viewed it was evident that service users receive support in their personal care needs and in accessing health and specialist services in order to meet their individual needs. The staff were observed in encouraging a relaxed and unhurried atmosphere, whilst supporting service users in getting up and participating in activities. Medication storage and recording systems were viewed. All medications were locked in a safe storage facility. All staff responsible for assisting with administration had received training. A second member of staff witnessed all medications administered; this was seen as good practice, however amendments needed to be made to recording systems in place to ensure that Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 15 the home are working in accordance with Data Protection legislation. . Recommendations have been made for improvement in this area. The home have guidelines on the use of PRN medication, however, these guidelines were not being followed in their entirety. A requirement has been made for improvements in this area. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 16 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 poor. This judgement has been made using available evidence during a visit to the service. The complaints procedure is not up to date and easily accessible to service users and concerns and complaints have not been addressed appropriately. This does not ensure that service users are empowered. Staff are aware of and have received appropriate training in adult protection, thus ensuring the safety of service users. EVIDENCE: The home has a complaints procedure, however, this is not instantly accessible to service users and needs to be updated to include the current details of the service. It was noted during discussions with service users that concerns and complaints had been aired but it was not apparent that these issues had been addressed. This was confirmed by staff and from documentation viewed. Requirements have been made for improvements in this area. The organisation has an adult protection policy in place, this was reviewed in 2005. It was not clear from staff training files viewed whether protection of vulnerable adult training had been received, however, four staff confirmed that they had attended training in March 2006 with the Disability Trust. Certificates of training in this area will be viewed at the next visit to the home. Adult protection monitoring forms are completed in line with the local policy guidelines and reports are made if necessary. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 17 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 and 30 Quality in this outcome area is poor. This judgement has been made using available evidence during a visit to the service. Some areas of the home both internally and externally require redecoration, refurbishment and general maintenance to ensure that service users are provided with a comfortable and safe environment. EVIDENCE: A tour of the premises was carried out with one service user. There were some issues noted regarding poor decorations in some areas, in particular, the kitchen area, where flooring was in bad repair, cupboard doors were hanging loose and the ceiling was damaged from a recent leak in the shower room above. A number of cupboards were locked in the kitchen and service users felt that this detracted from the homely feel in this area. The garden, both at the front and rear of the property, was in need of urgent attention. This area was overgrown and did not provide a pleasant area for service users or their visitors. Requirements have been made for improvements in these areas. It was noted that some areas of the home had recently been decorated after consultation with service users. The leak to the shower room and subsequent Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 18 damage to the kitchen ceiling was being addressed by the housing department, who attended the home to assess damage during the inspection visit. Two service users allowed access to their bedroom and lounge areas during the visit. These areas were pleasant and were decorated with furnishings and personal items, which reflected the hobbies and interests of the occupants. The home was clean and hygienic at the time of the visit. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 19 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, 35 Quality in this outcome area is adequate. This judgement has been made using available evidence during a visit to the service. Staff training is up to date in most areas, although only a small percentage have completed NVQ training in care. However, the training received will enable staff to meet the current needs of the service user group. Recruitment practices are robust and protect service users. EVIDENCE: From discussions with staff, completed questionnaires and from training files viewed it was confirmed that staff training is up to date in most areas, this includes mandatory training and training in specialist areas. Only 28.5 of care staff are trained to NVQ level 2 or above in care. Recruitment files were viewed and documentation regarding agency staff used. Records were found to be up to date and in order. Staffing rotas and the allocation of staffing to each shift was discussed with the staff and the unit general manager. It would appear that, although staffing numbers are currently adequate, staff are not allocated at appropriate times of the day according to the needs of the services users. A recommendation has been made for improvement in this area previously within this report. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 20 Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 21 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, 39 and 42 Quality in this outcome area is poor. This judgement has been made using available evidence during a visit to the service. The home does not have a manager at present, however, service users benefit from a reasonably well run home. Quality assurance systems need to be addressed to ensure that practices are reviewed and that the home is developed. Health and safety systems protect the safety of service users. EVIDENCE: The home has not had a manager in place now for some months. The management is overseen by the unit general manager, Tony Rodriguez, who will visit the home weekly and is available for consultation by telephone if necessary. This was confirmed by staff and from the visitors’ book. Mr Rodriguez confirmed that the recruitment of a new manager is in presently in progress. A number of the staff team have been working in the home for a several years and have provided service users with consistency and comfort in the Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 22 knowledge that staff know their needs. However, the over all ethos of the home did not have a feeling of enthusiasm and staff did not appear to be proactive in looking for ways to improve the service. This will, hopefully, be addressed through the appointment of a new manager. Quality assurance is currently assessed through regular service user and staff meetings, visits from the organisation and from open discussions with service users. However, an overall quality audit of the service has not been carried out for several years. A requirement is made for improvement in this area. Health and safety documentation and systems in place were viewed. These were found to be satisfactory at the time of this visit. Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 23 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 2 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 1 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 2 32 X 33 X 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 2 2 X X 3 x Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 24 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 YA7 Regulation 12 Requirement It is a requirement that the organisation addresses the issues of conflict between service users in the home and ensures that service users are still satisfied with their placement. It is a requirement that practices are reviewed for PRN medications and that amendments are made to the procedure in place for the witnessing of medications administered. It is a requirement that all concerns and complaints are addressed appropriately and that service users have access to the complaints procedures. It is a requirement that all areas of the home are suitably decorated and maintained. It is a requirement that the organisation carry out a quality audit of the whole service and that any shortfalls noted are addressed appropriately. Timescale for action 31/07/06 2 YA20 13 31/05/06 3 YA22 22 30/06/06 4 5 YA24 YA39 23 24 31/08/06 31/08/06 Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 25 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 YA1 YA6 Good Practice Recommendations It is recommended that the home make some amendments to the service users guide and ensure that service users have access to this document at all times. It is recommended that further improvement could be made to care plans to identify the levels of support required in reaching personal goals, how they will be achieved and within what timescale. It is recommended that all risks are identified and risk assessments carried out. It is recommended that activity plans are re-addressed to ensure service user choice and that staffing is allocated according to the needs of service users. 3 4 YA9 YA14 Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 26 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Stolford Rise (49) DS0000015082.V290326.R01.S.doc Version 5.1 Page 27 - 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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