Inspection on 25/10/05 for 52 Russell Terrace

This inspection was carried out on 25th October 2005.

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 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 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

52 Russell Terrace 10/09/07

52 Russell Terrace 31/07/06

52 Russell Terrace 07/06/05

52 Russell Terrace 15/02/05

52 Russell Terrace 10/08/04

52 Russell Terrace 19/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 52 Russell Terrace 52 Russell Terrace Leamington Spa Warwickshire CV31 1HE Lead Inspector Martin Brown Unannounced Inspection 25th October 2005 10:00 52 Russell Terrace DS0000058003.V257395.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 52 Russell Terrace DS0000058003.V257395.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. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 52 Russell Terrace Address 52 Russell Terrace Leamington Spa Warwickshire CV31 1HE 01926 431471 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) Turning Point Miss Tracey Bates Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (4) of places 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Age Range of Service Users People admitted to the home must be in the age range of 18 to 64 years. 7th June 2005 Date of last inspection Brief Description of the Service: The home is registered for six adults with learning disabilities. It offers a service to people with complex needs and communication difficulties. Turning Point operates the home; it is a national organisation that provides services to people with learning disabilities and drug and alcohol problems. The home is a converted Georgian house, which has been extended to provide additional kitchen and bedroom space. Accommodation is on two floors. There is a bathroom on each and a separate WC on the mezzanine level. The ground floor has been adapted to provide level access to, and within, the home for wheelchair users. There are two bedrooms on the ground floor in addition to the lounge and dining/ kitchen area. There is a laundry/conservatory area at the rear of the house. There is a garden with a swing, vegetable patch and sensory area. 52 Russell Terrace DS0000058003.V257395.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 that started on a Tuesday morning and lasted for two hours. Staff, manager, and the people living at the home were welcoming and helpful. Everyone living at the home was present and spoken with at some point during the inspection. This was the second inspection of the year, and largely addressed issues outstanding from, or not looked at during, the previous inspection. What the service does well: 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. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 6 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 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were met during the previous inspection and not assessed on this occasion. There have been no new admissions to the home. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 8 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): 6,9 Individual plans are detailed and wide-ranging, but specific needs, risks, and behaviours could be clearer in some instances. Because staff are familiar with individual risk issues, they tend not to detail them as thorough a way as might be needed by those unfamiliar with the risks. EVIDENCE: Residents’ care plans continue to be comprehensive, and made more accessible to residents by the use of photographs. One service user happily spent time leafing through his folder, looking at the photographs inside. Risk assessments, completed to a standard ‘Turning Point’ formula, were seen to be in place; these were supplemented by far more individual ‘guidelines’ outlining the risks posed by particular needs and behaviours. These had been compiled by staff who were familiar with the service users, and were not, in some of the examples looked at, sufficiently detailed as to fully explain the exact nature of the risk and the action to be taken to manage it. This was discussed with one of the staff team who is to review these. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 9 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 Service users continue to enjoy a wide variety of activities on an individual basis. EVIDENCE: The key standards in this section were all met during the previous inspection. Observation, discussion with staff, residents and the manager demonstrated that they continue to be met. A number of day services used by residents at the home were shut for the week, staff were ensuring people had the opportunity to go out for short trips out to the shops or to a café, for example, with one to one support. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 10 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 Service users continue to receive personal support in ways that they are comfortable with. EVIDENCE: These standards were satisfactorily met during the previous inspection. Observation and discussion with staff and residents demonstrated that the home continues to enlist specialist support where necessary, and to meet individual support needs with appropriate individual responses. Staff were able to highlight significant current issues and to highlight how they were managed in the most suitable manner. Residents, whose needs vary a great deal, all presented as relaxed and comfortable with each other, with staff, and their surroundings. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 11 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 The ethos of the home helps ensure that service users’ views are listened to and that staff make genuine attempts to understand those views. EVIDENCE: A complaint had recently been made and been satisfactorily investigated by the service manager. Details of this had been seen previously; it was not yet available in the home. Guidelines were seen in individual folders on making a complaint. These recognise that individual residents may have difficulty with the concept of complaints and complaining and guides staff towards recognising signs that a person may be unhappy about aspects of their lives and to take appropriate action. All service users have contacts with relatives or outside agencies. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 12 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): 24,25,27,28,29,30 While the home overall continues to be homely, attractively furnished, decorated and well-maintained, there continue to be areas that could benefit from improvement. Facilities need to be put in place, most notably a lift, to enable residents who may be becoming frailer to remain at the home. EVIDENCE: The lounge, kitchen, and individual bedrooms are of a high standard. The downstairs bathroom and a portion of a downstairs bedroom are currently being renovated, to improve facilities and to permanently get rid of unpleasant odours. While this is being done, residents on the ground floor are having to use the upstairs bathroom, with staff support. The conservatory is used and liked by at least two residents, despite it sharing the space with the laundry facilities. Windows here still require attention. The front of the house has flaking paint and a rotting window frame. The side gate to the home is also rotting. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 13 The manager advised that people in the home would feel more secure with a more substantial door than the current one. She also advised that the needs of one resident in particular are now such that a ‘keypad’ activated lock on the front door would also be safer. The manager advised that a lift has been agreed on in order to meet the anticipated needs of residents, and that covers have been ordered for all radiators. The door to the toilet on the landing ‘rests’ in a partly open position, presenting an obstacle and potential hazard to people using the stairs. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,34,35 Service users continue to benefit from an effective staff with whom they are familiar and who are familiar with their needs and wishes. Recording of Criminal Records Bureau checks needs to be clarified. EVIDENCE: Staff showed themselves familiar with the needs of the residents and to be effective at meeting those needs. One agency staff on duty was a person who had worked at the home consistently and was familiar to everyone there. One newer member of staff was able to learn from the core of experienced staff as well as the written guidelines and the induction programme. Training was underway for staff in a number of areas, with mandatory training such as First Aid, Moving and Handling, medication training having either taken place, been updated, or imminent. Dementia awareness training is still to take place; the manager advised that there had been difficulty in accessing a suitable course from the preferred trainers. The most recently recruited member of staff was positive concerning the recruitment and induction process. Staff files were seen to include appropriate information. Details of Criminal Records Bureau checks were seen. There was no written confirmation by the manager that Criminal Records Bureau checks were seen and that they were satisfactory. An updated pro-forma for agency staff was seen. This asks for confirmation of a Criminal Records Bureau check, but not whether it is a satisfactory one – that is, one free of relevant convictions. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 15 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): 37,42 The home is well-run; in view of the manager’s recent additional responsibilities a deputy is needed to ensure this continues. Additional fire precaution measures will make residents safer. EVIDENCE: The manager has recently taken on the additional role of service manager, widening her responsibilities to beyond that of just the home. As this lessens the time she is available to attend to matters directly concerning Russell Terrace, a deputy is to be appointed to ensure that sufficient support is forthcoming to enable the home to continue to be run effectively. Following the last inspection, the manager advised that she has discussed fire procedures, particularly the night time procedure, with the fire officer and with the night staff, and that they are all clear on how the night procedure differs from the day procedure. This procedure has not yet been confirmed in writing. The manager advised that only staff who are familiar with Russell Terrace are used for night duties. Upstairs doors do not have alarm activated fire closures on them. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 16 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 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x X 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 2 3 2 3 LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score x x 3 2 2 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 52 Russell Terrace Score 3 3 X x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x DS0000058003.V257395.R01.S.doc Version 5.0 Page 17 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 YA27 Regulation 16(1) Requirement The renovation of the downstairs bathroom and bedroom must be completed as speedily as possible, whilst ensuring it minimises any future risk of unpleasant odours developing there. The front of the house, most notably a rotting window frame and a rotting gate, requires attention. The installation of a lift is required. (This is outstanding from the previous inspection). Dementia training is required for all staff. The manager must have in place written confirmation that satisfactory Criminal Records Bureau checks have been seen for all contracted staff. A deputy manager is to be appointed. The night-time fire procedure is to be recorded. Upstairs bedroom doors must have alarm-activated fire closures on them. The door to the toilet on the landing must ‘rest’ in a shut position. DS0000058003.V257395.R01.S.doc Timescale for action 28/11/05 2 YA24 16(1) 28/01/06 3 4 5 YA29 YA35 YA34 23 18 19 28/01/06 28/11/05 28/11/05 6 7 8 9 YA37 YA42 YA42 YA42 18 23(4) 23(4) 13(4) 28/11/05 28/11/05 28/11/05 28/11/05 52 Russell Terrace Version 5.0 Page 18 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA6 YA28 YA24 YA34 Good Practice Recommendations It is recommended that individual risk assessments and guidelines cover more detail when reviewed. It is recommended that the conservatory, which appears to be much valued by residents, be extended to make it separate from the laundry. It is recommended that the front door be made more secure. The agency staff pro-forma should clearly ask whether a Criminal Records Bureau is satisfactory or not. 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 52 Russell Terrace DS0000058003.V257395.R01.S.doc Version 5.0 Page 20 - 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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