Inspection on 07/06/05 for 52 Russell Terrace

This inspection was carried out on 7th June 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

52 Russell Terrace 10/09/07

52 Russell Terrace 31/07/06

52 Russell Terrace 25/10/05

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 07 June 2005 10:30 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 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 Stationary 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. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 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 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 CRH Care Home 6 Category(ies) of LD Learning disability Number 6 registration, with number LD (E) Learning disability - Over 65 Number 4 of places E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Age Range of Service Users: People admitted to the home must be in the age range of 18 to 64 years. Date of last inspection 15 February 2005 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. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place in the middle of the day, and lasted four hours. The inspector was made welcome by staff, the manger, and residents, and was able to speak to all residents, a number of staff, and the manager. 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. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 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 standard(s) 2,4 Service users’ needs and aspirations are assessed, and they have suitable time and information to decide that the home is right for them. EVIDENCE: One service user had moved in since the previous inspection; the moving in process had been sufficiently gradual so as to allow the placement to be fully ‘test driven’ and for the home to be able to be sure it could meet her needs. The service user made it clear that she was very happy with the move, and care plans and assessments showed that the home was able to meet her needs, including the provision of a ground floor room. A life history book is being developed with the service user. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 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 standard(s) 6,7,9 Assessed needs are reflected in individual care plans. Where needs have recently changed, or are changing, interim guidelines or risk assessments should be developed to ensure that staff are managing needs in a consistent and effective way. Risk assessments should concentrate on specific, identified individual risks. The home is to be commended in the natural way it involves service users in decision-making and choices. Staff should continue to make extra effort to assist those service users less able to make opinions and choices known. EVIDENCE: Service users’ care plans detailed their needs and goals. Each service user also has a life history book. There were detailed risk assessments provided by Turning Point to cover almost every activity undertaken by service users. Alongside many of these were briefer, more accessible guides to particular activities, often accompanied by a relevant photograph. One service user had developed a liking for grass, plants, and exploring other objects with her mouth. Staff and the manager advised that this was a very recent reoccurrence of something the service user had done many years ago. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 9 There was uncertainty on how this was managed, with her being escorted in the garden at one point, ‘in case she tries to eat something’ and later being on her own in the garden. Service users were seen to be involved informally during the inspection, in such matters as suggestions for shopping and lunch, although this tended to centre on the most vocal service users. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 10 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 standard(s) 12,13,14,1516,17 Service users are able to take part in a variety of appropriate activities, maintain relationships, and have a healthy, varied diet that they enjoy. EVIDENCE: All service users have a varied and flexible activities timetable. Activities take place within the home and in the wider community. At least one service user is a talented artist, and the home has mounted and displayed her work in an attractive way. Two service users enjoyed a day out at a butterfly farm on the day of the inspection; others went out for various activities at different points in the day. Some service users were able to discuss favourite activities and places they had recently been, and to talk about things they were looking forward to.Helped by the nearness of the local town, park and other amenities, service users are able to be part of the local community, going to local pubs, coffee shops, the park and shops. One service user maintains regular contact with someone she is fond of from her previous home. There is a varied and flexible menu, meeting service users’ wishes within a framework of healthy diets. The kitchen was well-stocked, enabling the home to respond to service users’ requests at lunch time. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 11 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 standard(s) 18,19,20 Service users’ individual support needs are met as required, in a sensitive manner, supporting their emotional, as well as physical needs. Medication is administered appropriately. EVIDENCE: Support needs are detailed in individual care plans. One service users’ communication guide set out very clearly how she communicated. Most of the staff had worked at the home for a long time and were familiar with service users’ needs, and recognised where these were changing. Medication procedures were good, with clear guidelines, photographs of service users, outlines of what medication was for, and accurate recording. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 23 Service users’ finances are effectively and safely managed. EVIDENCE: These standards were met at the previous inspection. A sample of service users’ monies and its recording was looked at, and found to be accurate. Recording procedures are sound. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 13 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 standard(s) 24,25,26,27,28,29,30 The home provides a safe, homely and comfortable environment for service users. Service users may benefit from a larger conservatory that is separate from the laundry area. It is vitally important that disability aids such as bathchairs continue to meet the needs of service users. The increasing age and decreasing mobility of service users makes the installation of a lift a pressing issue. EVIDENCE: The home is mostly very attractively decorated and well-maintained. Service users’ bedrooms, in particular, have been decorated particularly well to suit the individual needs, wishes and interests of their occupants. The garden is accessible and includes a swing and a sensory area. There is one step on the route around the garden, which the manager advised is to be levelled. There have been problems regarding the recently installed bath chair. The manager advised that this has recently been fixed, but that she has not been happy with the service provided by the company that supplied the chair. On the day of the inspection it was working satisfactorily. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 14 Paint has flaked from windows at the front of the house and on the conservatory, exposing bare wood underneath. The conservatory was wellused by residents during the inspection, but is rather cramped for use by more than two at a time, especially as it shares its space with the laundry. There was a bare lamp at the top of the hall landing; this along with cracks in the ceiling, detracted from the overall positive effect. The home was clean and hygienic, other than one bathroom and bedroom, where the manager advised that solutions are being sought for the management of urinary continence issues. Four of the service users are in upstairs rooms; the installation of a lift, rather than a stairlift, is now being proposed, in order to meet anticipated needs of service users situated upstairs. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 15 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 Service users benefit from an effective staff team who are familiar with their needs and wishes. Further training opportunities will help equip staff to meet future needs. EVIDENCE: The home was well-staffed during this unannounced inspection, enabling service users to undertake individual activities. Agency staff continue to be used, although the manager and staff advised that this is now to a lesser extent than previously, and both the agency staff seen were regularly used and familiar with the home and the service users. One agency worker had in fact applied to be a permanent member of Turning Point staff at the home last August, but the process had still not been completed. Staff were positive about the home and commented that training opportunities had improved. Turning Point have provided training in core areas; dementia training is planned for all staff with Stratford college. The manager advised, and rotas confirmed, that night duties were always covered by regular, permanent staff, with other permanent staff covering on rare occasions. The manager also advised that the home was still waiting for at least one permanent vacancy to be filled, and was concerned at having to return to an over –reliance on agency staff. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 16 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39,42 Service users’ views are sought, and staff and management otherwise endeavour to anticipate these wishes. The home promotes service users’ health and welfare; it needs to ensure that service user access to bedrooms does not compromise fire safety. EVIDENCE: Monthly service user meetings take place and all service user comments are recorded. Discussions with staff, management, and service users, and observation of practice demonstrated that genuine efforts are made to interpret and meet service users’ wishes. Individual holidays have been arranged to meet service user preferences, and such things as the layout and design of the garden has been done to provide stimulation for individual service users. Risk assessments are in place. A fire procedure was clearly displayed; but this dealt only with the day time procedure. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 17 The manager advised that night staff are fully aware of the night time procedure, and is to ensure that this is referred to on the general procedure. There are magnetic closures on all downstairs fire doors, but not on those bedroom doors upstairs, some of which were wedged open. The manager is to discuss this practice, normally regarded as unacceptable, with the Fire Officer, and purchase similar closures to those downstairs, as required. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 18 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 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 3 2 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x 2 x E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 19 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 6 Regulation 13 Requirement The home must ensure that specific, identified risks are managed with the use of risk assessments. A lampshade is required for the landing light. The home is required to meet the increasing mobility needs of service users by installing a suitable lift. Training for all staff, to meet service users needs, is to be completed. The home is required to ensure that fire safety procedure and practice, in consultation with the Fire Officer, is adequate, and to install fire closures on bedroom doors where necessary. Identified windows are to be repaired or replaced. The home must confirm the appointment of at least one more permanent staff, and avoid an over-reliance on agency staff. The home must eliminate the odour in one bathroom and bedroom. Timescale for action 21/6/05 2. 3. 24 29 23 23 21/6/05 21/9/05 4. 5. 35 42 18 23(4) 21/7/05 21/7/05 6. 7. 24 33 23(2)(b) 18 21/8/05 21/7/05 8. 30 16(2)(k) 21/7/05 E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 20 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 24 24 Good Practice Recommendations It is recommended that the hall area, particularly the ceiling , is redecorated. It is recommended that plans are formulated to improve the conservatory, and separating it from the laundry. E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 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 E53 S58003 52 Russell Terrace V231335 070605 Stage 4.doc Version 1.30 Page 22 - 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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