Inspection on 14/09/05 for 50 -51 Quarry Road

This inspection was carried out on 14th September 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

50 -51 Quarry Road 15/10/08

50 -51 Quarry Road 25/01/07

50 -51 Quarry Road 11/01/06

50 -51 Quarry Road 23/02/05

50 -51 Quarry Road 24/08/04

Similar services:

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Ashley House

Ascot Nursing Home

Fountain View

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

CARE HOME ADULTS 18-65 Quarry Road (51) 51 Quarry Road Ryde Isle Of Wight PO33 2TY Lead Inspector Annie Kentfield Unannounced Inspection 14th September 2005 15:45 Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Quarry Road (51) Address 51 Quarry Road Ryde Isle Of Wight PO33 2TY 01983 616862 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) Mrs Lynda Margaret Lawlor Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home currently accommodates one resident over 65 years of age. Date of last inspection 23 February 2005 Brief Description of the Service: 51 Quarry Road is a small care home owned and jointly run with 50 Quarry Road. The two homes are separately registered although the owners are considering applying to change this to one registration for both homes. The two homes offer flexible and informal family based care and support to five residents who have experienced difficulties with their mental health. The two houses, one semi-detached and one detached, are located at the end of quiet lane in a pleasant residential area of Ryde and there is a large garden area and an area of land where the owners keep ducks and chickens. As separately registered homes, there are separate inspection reports for 50 and 51 Quarry Road based on one joint inspection but both reports refer to 50 and 51 Quarry Road collectively as “the home.” Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection and took place in the late afternoon/early evening when it was more likely that the residents would be at home. The inspector was able to meet three of the five residents and also inspect some of the home’s records with the registered manager. Although 50 and 51 Quarry Road are not attached houses, there is only a small paved area between the two properties and residents use the facilities in both houses very easily. Inspection comment cards were left for residents/visitors to complete and return to the Commission if they chose. What the service does well: What has improved since the last inspection? What they could do better: The registered manager has only partially met a requirement from the previous inspection – to demonstrate that periodic training is undertaken to update knowledge, skills and competence in the areas of mental health good practice Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 6 and safe working practice. The manager has attended a one-day training update on medication in April of this year. However, the home does not have any person with a First Aid qualification and the manager has been given six months to comply with this requirement. The other previous requirement to ensure that the registered manager is enrolled to achieve the National Minimum Standard qualifications for registered managers – has not been met. These are again requirements and the registered manager must specifically ensure that either the manager or the co-owner has some relevant First Aid training and in addition, demonstrate a commitment to meeting the qualification requirements for the managers of care homes. For care homes, registered managers are expected to have two qualifications – one of these has to be relevant to the care they are responsible for such as a qualification in nursing, social work or the NVQ level 4 in care. The second qualification should be in managing care services, either the NVQ level 4 in management or the NVQ level 4 registered manager award. 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. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 3 and 4 Since the last inspection a new resident has moved into the home and there is a record of an assessment being carried out. The new resident moved in after first visiting the home. EVIDENCE: Most of the residents have lived in the home for some time, however, prospective residents are positively encouraged to visit the home, stay for a meal, or stay for a trial period, before deciding to move into the home. All initial care needs assessments for prospective residents are done by the manager and records show that relevant information for the assessment is provided by care managers, community nurses and all other people involved in the care of the resident including family. The manager only admits new residents who meet the home’s categories of registration; where the manager is clear that the care needs can be met by the home; and that the needs of existing residents are taken into consideration. The home provides social and emotional support and care and is able to meet the care needs of residents who are independent and mobile. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 - 10 All residents have an agreed individual care plan. Residents are encouraged to take part in all aspects of daily life in the home. EVIDENCE: The inspection looked at all of the residents’ individual care plans. Where a resident is registered on the Care Programme Approach (CPA), the care plan is reviewed with the resident, the home manager and all others involved in the resident’s care, at agreed intervals (either six months or one year). However, it was noted that one care plan has not been formally reviewed under CPA for some time and in discussion it was recommended that the registered manager follows this up with the community care co-ordinator to ensure that all care plans are regularly reviewed and a copy given to residents and a copy kept in the home. This is particularly important where there have been changes to the care plan or changes to medication. Other individual care plans are reviewed annually in a formal care review with the resident, the registered manager and the relevant care manager or care co-ordinator and a written and signed copy of the review is kept by the resident and the home. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 10 Residents are encouraged to take individual responsibility for their own rooms and to do their own laundry where possible. All of the residents are given a weekly allowance by the home for undertaking household tasks such as cleaning and washing up. One resident said that they liked the weekly routine of cleaning and other duties and it helped them to learn useful skills for a possible move into their own home at a later date. Residents spoken to said that they looked after their own finances, and records show that residents are responsible for paying their care fees to the home and the manager does not look after any monies for the residents. As a small family run home, the daily living routines are informally agreed and usually residents get together each day for the evening meal, and this is also an opportunity for the residents to socialise and discuss day-to-day issues that may arise. Residents are encouraged to take responsible risks and have all agreed to the home’s policy on the use of alcohol, smoking and consideration for everyone living in the home. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 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): 11 - 17 All of the residents spoken to were happy with their own routines of planned activity each week. EVIDENCE: Residents are supported and encouraged to develop their own daily routines that include voluntary work, social and leisure activities, and maintaining contact with family and friends. The manager works closely with the community mental health team to ensure that residents have information and choice about work and leisure opportunities. Privacy and choice are respected in the home and residents said that they like having their own room to spend time in when they want to, and also enjoyed those activities they take part in outside of the home. The manager operates a weekly allowance system for the residents who have particular domestic tasks in the home each week. The residents are happy with this system. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 12 The manager will provide transport where necessary if residents need to travel, as the home is some distance from public transport. It was evident that the atmosphere in the home is relaxed and informal and residents have independence and freedom of movement within the home, and as agreed in their individual care plans. Residents said that they are happy with the meals provided. Residents usually get their own breakfast and the manager cooks the main evening meal. Residents can have lunch in the home, take a packed lunch, or have lunch out. Menus tend to be informally arranged and alternatives offered to the main meal where the manager is aware of individual preferences and needs. The meals provided often use vegetables grown by the owners and eggs from the large number of ducks and chickens kept by the owners. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 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 – 20 The residents’ physical and emotional healthcare needs are met by the home. Most of the residents are self-medicating and systems are in place to manage medication where agreed. EVIDENCE: The manager works closely with the community mental health team and any health issues are immediately identified and a referral arranged with the resident’s GP. If residents choose, the manager will accompany residents to GP or out patient appointments. Where residents choose to self-medicate, the manager provides lockable storage space and monitors medication with the resident. Medication records were inspected and the manager has devised a medication administration sheet to record medication for one resident. It is recommended as good practice that the record of medication dispensed should be initialled by whoever gives the medication. The manager is able to contact either the care co-ordinators or GPs if there are any concerns about residents’ medication or side effects. Residents are registered with the GP of their choice in the local area. All of the residents are independent in personal care and the manager’s role is to provide prompting, support or advice where a need is identified. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 14 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 and 23 Residents said that they were happy in the home and had no complaints. EVIDENCE: As a small family run home that does not employ any staff, the manager who has daily contact with the residents deals with any complaints that may arise. Any complaints are recorded but the records show that there have not been any complaints or incidents for many years. The manager is aware of the local adult protection policy and procedures and of the Protection of Vulnerable Adults Scheme (POVA), but as the home does not employ any staff this was not inspected. The residents spoken to are able to make their own decisions and all have access to additional support from their community care co-ordinator if they need to. The manager demonstrated a good knowledge and awareness of the residents’ needs and abilities and is able to access specialist services to support residents whenever needed. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 15 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 Residents live in a comfortable, homely and safe environment, sharing a domestic residence with the registered owners. EVIDENCE: Residents have their own door key and can come and go as they wish although they are asked to let the manager know if they are going to be out late or not in for meals. A small courtyard separates 50 and 51 Quarry Road and there are 3 residents’ bedrooms in 51 Quarry Road and 2 residents’ bedrooms in 50 Quarry Road. There is a kitchen, dining room and sitting room in 50 Quarry that is shared by the residents and residents can also use the kitchen and a small sitting room in 51 Quarry Road. The grounds are extensive with several dedicated areas to sit outside, and the gardens are well looked after and planted to look very attractive. Some of the bedrooms have a wash-hand basin and all of the bedrooms are close to a toilet and bathroom. There are designated smoking areas with some restrictions on smoking in the dining room during mealtimes. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 16 Both properties are well maintained by the owners and since the last inspection one of the bedrooms has been decorated and re-carpeted and further internal decoration is planned. Residents all have their own bedroom and these are personalised as they choose. The owners have provided a television in each room, and although the bedrooms vary in size, residents expressed satisfaction with their own rooms and like having their own private space to spend time in when they want to. There is also a television and music centre in the sitting room of 50 Quarry Road for the use of all of the residents. The home is clean and tidy and residents clean their own rooms and undertake some of the household tasks such as washing up, laundry, changing beds etc. Health and safety procedures have been discussed at previous inspections and the manager has followed the recommendation to seek advice from the Environmental Health Department. As the residents are mobile and independent and the premises are domestic in scale, it was advised that the home does not need to cover radiators or provide separate hand washing facilities. The risk assessment has not changed. The home does not provide any special adaptations or mobility equipment, as the residents are able to independently access the stairs and use the bathrooms without assistance. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 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): 34 The standards about staffing were not assessed because the home does not employ any staff. Standard 34 was assessed because a previous inspection recommended that all family members working with the residents should have a current Criminal Record Bureau check, as good practice. EVIDENCE: The inspector noted that the owners and two members of the family all have current CRB checks and these were looked at during the inspection. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 - 43 The home is efficiently run and managed in the best interests of the residents. Records are maintained by the home as required by the National Minimum Standards and Care Homes Regulations 2001. EVIDENCE: The home is owned and managed by proprietors who live on the premises with the residents. One of the owners is the registered manager with day-to-day responsibility for the home. The registered manager has run the home for many years and has extensive experience of working with the residents. In order to meet the minimum qualification standard for managers of care homes, the registered manager needs to demonstrate a commitment to achieving qualifications in care and management to NVQ level 4 standard. The alternative would be to appoint another manager who was willing to achieve these qualifications and apply to become registered manager. In discussion, the manager agreed to a timescale of December 2005 to be enrolled to achieve the required qualifications. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 19 The National Minimum Standards also recommend as good practice that registered managers continually update their professional practice in areas relevant to the needs of the residents in the home. Since the last inspection, the manager has updated her training in the safe use of medication. Previous inspections have recommended that at least one person who has responsibility in the home should have some training in basic first aid. This was discussed again with the manager, during the inspection, and it was agreed that the requirement to arrange training in first aid at the required level of competency would be met within the agreed timescale of six months. As a domestic property, with no employees, the home is exempt from many of the workplace regulations relating to health and safety. However, the Care Homes Regulations require the home to ensure that suitable procedures are in place to ensure that the residents are protected and that there are procedures for fire safety, at all times. Records show that the fire alarm system is regularly checked and there is fire safety equipment in the kitchens. It is recommended as good practice that the manager take steps to ensure that residents know how to use fire safety equipment and that residents know what to do in the event of a fire, by means of practice fire drills, at irregular intervals. Records inspected during the course of the inspection were in good order and are securely stored in an office. The home does not have any formal system of quality monitoring because it is a small home and the manager and residents communicate informally on a daily basis. Residents told the inspector that they would speak to either of the owners if they were concerned about anything. The manager confirmed that the home is financially viable and there was evidence that the home is insured with sufficient public liability. The inspector observed that the care approach of the home is friendly and relaxed and residents confirmed this in discussion during the inspection. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 3 3 x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x x x 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Quarry Road (51) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x 3 2 3 DS0000012585.V249130.R01.S.doc Version 5.0 Page 21 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard 31 Regulation 9 Requirement The registered manager must demonstrate how they are going to achieve the minimum qualifications in care and management (for managers of registered care homes). The registered manager must make arrangements to ensure that there is at least one responsible person in the home with a First Aid qualification at the required level of competency. Timescale for action 30/12/05 2 42 13(3) 30/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 42 Good Practice Recommendations It is recommended as good practice for the manager to make sure that residents know how to operate fire safety equipment and know what to do in the event of a fire. Any fire safety training or practice fire evacuation should be recorded with the names of those attending. Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Southampton, Portsmouth and Isle of Wight Ground Floor Mill Court Furrlongs Newport, IOW PO30 2AA 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 Quarry Road (51) DS0000012585.V249130.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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