Inspection on 20/12/05 for 50 Vassal Road

This inspection was carried out on 20th December 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

50 Vassal Road 17/01/07

50 Vassal Road 18/02/05

50 Vassal Road 09/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 50 Vassal Road Fishponds Bristol BS16 2LW Lead Inspector Sandra Jones Unannounced Inspection 20th December 2005 09:30 50 Vassal Road DS0000026581.V270097.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 50 Vassal Road DS0000026581.V270097.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. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 50 Vassal Road Address Fishponds Bristol BS16 2LW 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) 0117 9586515 0117 9709301 Aspects and Milestones Trust Claire Maine Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 6 residents aged between 19-64 years Date of last inspection 21st June 2005 Brief Description of the Service: 50 Vassal Road is operated by the Aspects and Milestones Care Trust and is registered to provide accommodation and personal care to six people aged 18-64 with learning disabilities. The house is situated in a residential area close to local shops and ameneties. It provide single occupancy accommodation with two lounges. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection for the year 2005/2006. Residents and members of staff on duty were consulted on the standards of care at the home. Records, policies and procedures were used to confirm the standards of care. What the service does well: What has improved since the last inspection? Since the last inspection a conservatory was constructed to be used as an office, providing residents with full use of their communal space. The home continues to implement requirements within the given timescales. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 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. 50 Vassal Road DS0000026581.V270097.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 50 Vassal Road DS0000026581.V270097.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): These standards were not examined at this inspection. EVIDENCE: 50 Vassal Road DS0000026581.V270097.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, 7 & 9 The reviewing process must be made clearer. Records of reviews must be maintained and amendments documented onto ELP’s. The manager must discuss with residents their right to privacy of information to make decisions about the future location of their ELP. Members of staff endeavour to empower residents to make choices about their daily living. Risk assessments must be reviewed to ensure that residents benefit from appropriate management strategies. EVIDENCE: Residents case records contain personal information, medical notes, agreements and other documentation along with risk assessments. Essential Life Plans (ELP) are kept separate from the case records and pinned to the home’s notice board. While it is acknowledged that residents have access to their ELP, other residents and people that visit the home can access their plans. The manager must discuss with residents their right to privacy to reach 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 10 a decision about the location of the ELP’s. Individual ELP’s specify essential, important and preferences, with a description of the support needs using the key principles of privacy, rights, choice and inclusions. Short simple sentences and pictures are used to ensure that the people, its intended, can understand the ELP. Within the ELP’s there are amendments to reflect the changes in the individuals needs. However, the reviewing process that is in place is unclear. Where reviews take place the date, people present and action plans must be documents and amendments recorded within the ELP. The residents currently accommodated use verbal and other means of communications. ELPs clearly specify the actions that must be taken in response to gestures and sounds. To enable residents to make choices, the opportunities that must be presented to them is clearly described in their ELP. During the inspection, members of staff were observed enabling residents to make choices. Daily reports are used to list residents daily activities. For example, ceramics, Blackhorse day centre. The members of staff use a communication book to pass messages from shift to shift and mainly relate to house and staffing issues, with arrangements for 1:1’s. Appointments and visits are recorded in the home’s diary. Daily records describe activities, observations and outcomes of visits and within the records evidence that residents make decisions are recorded. For example, refusal to attend day services. Residents consulted described their daily routines and the support provided from their keyworker during 1:1. Additional comments were made regarding the provision of keys to the home and bedrooms which promotes their right to privacy. Two residents have full control of their personal allowance and the others have partial control. Residents have bank accounts and members of staff support residents to make withdrawals of cash for safekeeping at the home. Risk assessments are in place for activities that may involve and element of risk. Guidelines for diffusing aggressive behaviours are available to staff. While risk assessments were reviewed for one person, for two others the risk assessments were not up to date. Other assessments that focus on Health & Safety, fire evacuation and water temperature were completed. 50 Vassal Road DS0000026581.V270097.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): 12, 13 & 15 Residents have opportunities to experience a range of meaningful activities and employment. Residents access community facilities and participate in events and festivals. Family and friends are welcome at the home and staff support residents to maintain contact with them. EVIDENCE: Two residents attend college courses in photography, Out and About and general skills. Three residents are in paid employment and the other three residents receive expenses from Day Services they attend for tasks completed. Two residents deliver weekly papers and one is voluntarily employed locally. Residents accommodated visit local shops, access NHS facilities, eateries and parks with staff. One resident is independent and members of staff 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 12 accompany the others outside the home. Members of staff enable residents participation in local events and festivals. There is a home’s vehicle and residents contribute towards the running cost of the vehicle. Members of staff use the home’s transport to take and collect residents from their structured activities. Residents on 1:1 with their keyworker also use buses and trains. Where activities are organised in the evenings, one member of staff will accompany the resident and one will stay at home with the others. When evening activities are organised for more than one person additional staff are rostered. There are no restrictions on visiting at the home and three residents maintain links with family and friends. Visits to the home can take place in shared space and in residents bedrooms. It was understood from the staff that family members are invited to reviews and parties. Professional visitors sign the home’s visitors book and record the nature of their visit to the home. 50 Vassal Road DS0000026581.V270097.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, 19 & 20 ELPs detail the individuals personal heath care needs and incorporate their likes, dislikes and preferred routines for personal care tasks. Health care action plans lists the individuals needs along with guidance for staff to ensure residents health care needs are met. Records of administration must be signed immediately after administering medication to residents. EVIDENCE: ELP’s detail personal health care needs, likes, dislikes and preferred routines for personal care tasks. The residents currently accommodated are ambulant and do not require assistance from staff or equipment to move around the home. One resident received support from a physiotherapist and was using aids for mobility impairments and as there was a full recovery, aids were returned. The keyworker system is in operation at the home and keyworker mainly coordinate the care for the residents in their group. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 14 Health action plans are devised for each person, which lists the needs with a description of the actions to be taken by the staff. Additional details that relate their health needs is recorded - for example, scared of needles. Profiles are completed for residents that are epileptic and describe the types of seizures the person may experience. The nature, times and monitoring to take place is described. Health check questionnaires are completed by staff with the person which include mental health care needs and lifestyle choices. The format uses a tick box system with space for additional comments. From the questionnaire a summary with an action plan is developed. Documentation held within files evidence that residents are referred for hospital appointments and input from the CLDteam. Outcomes of visits to the GP, dentist and opticians are recorded and kept in case records. Medication profiles are in place for each person on regular prescribed medication. The purpose of the medication, side effects and compatibility with homely remedies are detailed within the profiles. Medication profiles for residents not on regular prescribed medications offer guidance on homely remedies that can be administered. One resident is prescribed with “when required” medications and guidelines were developed to instruct staff on the directions for administration. Medications are administered through a monitored dosage system by the staff. There were gaps found in the records of administration sheets indicated that records are not signed immediately after administration. Homely remedies are administered from a stock supply when required and the records are accurate and up to date. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 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 Residents are aware of the home’s complaints procedure. There is a clear commitment through policies, procedures and training to safeguarding residents from abuse. EVIDENCE: There were no complaints received at the home for investigation since the last inspection. Residents comments indicated their awareness of the complaints procedure. Policies and procedures that safeguard residents from abuse are in place and members of staff confirmed that POVA training is statutory. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 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): 30 The premises are kept clean and free from unpleasant odours and systems to control the spread of infection are in place. EVIDENCE: The home’s laundry is sited away from the kitchen. The floor and wall finishes can be cleaned easily. There is a washing machine and tumble dryer which is domestic in size. The max temp on the washing machine is 95 and it was understood that residents are not incontinent and sluicing facilities are not needed. The premises were found clean and free from unpleasant smells. 50 Vassal Road DS0000026581.V270097.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): 35 Training is accessible and undertaken ensuring that competent staff meet the changing needs of the residents. EVIDENCE: Members of staff reported, during the inspection, that training needs are discussed and identified during Personal Development Plans (PDP) meetings. Additional comments about statutory training and vocational qualifications were made. It was understood that staff must undertake statutory training that includes First Aid, Food Hygiene, manual handling and POVA. Other training specific to the needs of the residents is accessible through the Trust and following Foundation training, vocational training is available. 50 Vassal Road DS0000026581.V270097.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): 38 & 42 Members of staff are committed to an open culture, which benefits residents. Records are kept up to date and accurate which safeguard residents health and welfare. EVIDENCE: Feedback was sought from the staff on duty about the style of management used and the systems used to maintain consistency of care. Members of staff confirmed that individual supervision and staff meetings took place and ensured that the team was well supported. Members of staff commented about the closeness of the team and their commitment to empowering residents. The rota in place indicated that two staff are on duty throughout the day, with one person sleeping-in at night. 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 19 A record of food provided at the home is maintained. There is a standard breakfast, lunch for residents at the home and an evening meal for all the residents. Records demonstrated that the meals served are varied. Facilities for the safekeeping of cash and valuables exit at the home. Records of cash held on behalf of the residents are accurate and receipts are appended onto the records, further evidencing purchases made on behalf of the residents. The records that relate to fire safety policies, procedures, checks and practices were examined. Records confirmed that checks and practices are conducted at the stipulated frequencies. 50 Vassal Road DS0000026581.V270097.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 x x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 3 x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 50 Vassal Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x DS0000026581.V270097.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 YA6 Regulation 12(4)(a) Requirement The manager must discuss with residents their right to privacy of information to make decisions about the future location of their ELP. Reviews must be documented and ELP’s amended where appropriate Risk assessments must be reviewed Medication administration record sheets must be signed immediately after administration Timescale for action 30/05/06 2 3 4 YA6 YA9 YA20 15 13(4)(b) 13(2) 30/05/06 30/03/06 28/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 50 Vassal Road DS0000026581.V270097.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI 50 Vassal Road DS0000026581.V270097.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. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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