Inspection on 03/01/06 for 53 Cambridge Road

This inspection was carried out on 3rd January 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

53 Cambridge Road 29/05/08

53 Cambridge Road 17/05/07

53 Cambridge Road 15/06/06

53 Cambridge Road 06/09/05

53 Cambridge Road 24/03/05

53 Cambridge Road 07/03/05

53 Cambridge Road 18/03/04

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

CARE HOME ADULTS 18-65 53 Cambridge Road Portswood Southampton Hampshire SO14 6UT Lead Inspector Janet Shipman Unannounced Inspection 3rd January 2006 11:30 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 53 Cambridge Road Address Portswood Southampton Hampshire SO14 6UT 023 8055 1551 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) Choice Support Mr David Minett Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users in the category LD are only to be admitted between the age of 18 years and 60 years 6th September 2005 Date of last inspection Brief Description of the Service: 53 Cambridge Road is a large detached house, which provides care and accommodation to up to six people who have a learning disability. The home has six single bedrooms and has a large garden, which is accessible to all service users. Choice Support took over the home in 2004 and is now the registered provider. Cambridge Road is situated in Portswood, Southampton close to local amenities and has good transport links. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of 53 Cambridge Road. At the time of the inspection five of the six service users were out either shopping, spending time with a friend or attending day services. The service user who was in the home had chosen not to attend a medical appointment and wanted to stay in his room. The manager of the home is currently seconded to manage another Choice Support home. A senior support worker has been appointed as acting manager for the home during the seconded period. Initially a senior support worker assisted the inspector with the inspection until the acting manager arrived on duty. Although discussions were held with three service users upon their return to the home, the service users mainly talked about their thoughts and feelings about a fellow service user who sadly died unexpectedly a week ago. Full access to any information requested was provided with records and documentation identified in the report being viewed. What the service does well: What has improved since the last inspection? The home has now recruited to all its vacant posts and the acting manager said that she hopes that the new staff will be in post by the end of January to mid February. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 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. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Key standard 2 was assessed at the last inspection EVIDENCE: The standards were not assessed on this occasion. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 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): 7 Key standards 6 & 9 were assessed at the last inspection. The home promotes the rights of service users to make choices, partake in life decisions and participate in the day-to-day running of the home. EVIDENCE: Service users are able to make choices about their day-to-day life and decisions within the home through six weekly review meetings, where service users meet with their keyworker and review their care plans. Monthly residents meetings are held and minutes are taken. Discussions at the meeting include activities service users would like to participate in and issues affecting the home. The minutes from a recent meeting noted discussion around how people talk to each other and if someone is rude to another person how that can make them feel. Also listed was a whole range of leisure activities and holiday destinations that service users said they would like. A service user told the inspector that the meetings were helpful and that you can say what you want. A meeting is also held once a week to choose the menu, staff told the inspector that compromises have to be made in order to fit in everyone’s favourite meals and although this can be difficult at times, generally 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 10 everyone’s choices can be accommodated. One service user told the inspector that they really liked the food. During the inspection it was noted that care staff consulted service users, providing them with opportunities to make choices about the rest of the day. Questions were formulated in a manner that service users could understand and respond to. Only one service user currently manages their finances with some support by staff. The service user keeps the money in a locked money tin in their room and transactions are recorded with staff. Staff provide a higher level of support to the other service users in the house and their money is kept in lockable tins in the office and again all transactions are recorded. Service users are encouraged to collect their own benefits and pay the money into their accounts. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 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): 16 Standards 11, 12, 13, 14, 15 & 17 were assessed at the last inspection. Service users were seen to be treated with respect and have their privacy protected. EVIDENCE: Discussion was held with the service manager with regard to the recommendation made at the last inspection for the home to have a dedicated vehicle. Two service users whose mobility is decreasing could benefit from a vehicle and staff felt that they would choose to go out more if the home had a car. It was agreed that the manager could look at ways in which a vehicle could be purchased. Service users spoken with felt that their privacy was respected. One service user said that “staff always knock on the door” and that staff were “helpful”. The service user also said that she could talk to the staff about her sadness about the service user who died. Another service user said that they could spend time alone if they want to in their bedroom or one of the lounges. All service users have locks on their doors but only two service users lock their doors. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 12 The home has a mailbox and one of the service users collects the mail each morning and feels that this is their role. The service user will then deliver the mail to other service users or put it in the office for staff. Service users participate in the household chores, there is a rota detailing the daily tasks to be undertaken in the home and the names of service users undertaking the tasks. Service users also have time set a side each week for cleaning their rooms Staff were observed to interact with service users in a relaxed, friendly and respectful manner. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 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 Key standard 19 was assessed at the last inspection. The home ensures service users personal and health care needs are met in a dignified and respectful way. Medication is appropriately stored, dispensed and recorded within the home. EVIDENCE: Service users are supported by staff to meet their personal care and health needs and where there are specific issues these are documented within the care plan; for example, an outcome of a service user review was for female staff to assist the service user with her personal care needs. Referrals are made to the Specialist Health Care Teams for health related issues. One service user confirmed that they are supported to see a range of health professionals. The service user wanted the inspector to guess which health professional she would be seeing this week. The service user flexed her foot up and down and was pleased that the inspector guessed that she would be visiting the chiropodists. The service user also said that she was supported to see the dentists, opticians and doctors. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 14 Routines within the home appear to be flexible and times for when people get up in the morning is dependent on their timetable, daily commitments. There are no set times at night for service users to retire to their rooms. A monitored dosage system is used for the home. Staff receive training through their induction. Additional in-house training is being arranged by the manager to ensure that new staff are trained in administering medication as the corporate training was recently cancelled and the next training date is not until May 2006. The medication administration records were inspected and found to be maintained to the required standard. The medication is kept in a locked cupboard and the senior member of staff on duty holds keys. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 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 The home has a complaints policy and procedure which is available to service users. Staff treat service users with respect and are committed to protecting them. However, staff would benefit from further training around adult protection. EVIDENCE: The home uses a new format for recording complaints, which is documented on an Incident Form, and this is forwarded to the Service Manager who investigates the complaint. The number of complaints and outcomes are also logged on the quarterly reports, which are sent to the company’s head office. The home also holds six weekly reviews with service users and part of the review is to discuss any aspects of their care that they are not happy with. A service user has made one complaint since the last inspection. The complaint was investigated and resolved. There was also one adult protection issue referred to Social Services and this has now been resolved with the member of staff returning to work with a supervised plan of action. Some staff have received adult protection training. However, when the inspector spoke to staff they appeared unaware of some of the key aspects when dealing with an adult protection issue. This was discussed with the manager who agreed to hold a staff meeting to discuss the Protection of Vulnerable Adults inter-agency policy and invite a social services representative to talk through their role. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 16 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Standard 26 was assessed at the last inspection. The home offers a welcoming and comfortable environment for service users to live. The home is clean, tidy, well maintained and has no adverse odour. EVIDENCE: The accommodation has a warm and friendly atmosphere. The home is maintained and tastefully decorated throughout. All parts of the home are accessible. The home is owned by Downland Housing Association who has the responsibility for maintenance and the up-keep of the building. The manager reported that Downland are good at responding to maintenance requests. Recently the manager had called them out due to a large crack in part of the brick wall in the garden. Checks have been carried out and the wall is not deemed at risk of falling but further work would be carried out to brace the wall to provide extra safety. The manager has completed a risk assessment until the work has been completed. The kitchen needs redecorating and staff reported that they are waiting for this to be completed. The inspector was informed that service users are involved in choosing colours for re-decoration and when replacing furniture. Service users bedrooms were viewed and all 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 18 decorated to the service users request and furnished with their own personal belongings. A service user spoken with said that she really liked her room and loved living at Cambridge Road and “did not want to move anywhere else”. The home was found to be clean and tidy with no adverse odours. Service users are involved in the daily household tasks. Service users do their own clothes washing and drying. One service user was observed folding up the clothes that had just come out of the tumble dryer. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 35 & 36 Standards 32, 33 & 34 were assessed at the last inspection. The home has now recruited to all its vacant posts. Staff are appropriately trained, competent and supervised. However, the new Choice Support appraisal system needs to implemented as soon as the manager has had training to ensure staff receive a formal review once a year of their performance and have an agreed developmental plan. EVIDENCE: Care staff appeared to have a good knowledge and understanding of the service users needs and were observed interacting in a positive, warm friendly way with service users. The home operates a keyworker system. Each service user has a keyworker whose role is to ensure that the individual needs of the service user are met. Staff receive monthly to bi-monthly supervisions with the acting manager. However, the acting manager has had no formal training in this area, in-house training through shadowing was given by the previous manager. Supervision training has now been booked for the acting manager to attend. Supervision sessions cover induction, keyworking tasks, practice issues, extra responsibilities and training and development and are recorded. Staff spoken with confirmed that they receive regular supervision. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 20 The home has not yet implemented a formal appraisal system. Choice Support has developed a new system and the manager is waiting to attend the training to ensure that the system is delivered appropriately. The appraisal system will be viewed at the next inspection. The inspector joined a staff meeting being held in the afternoon. There was an agenda which staff were offered to contribute to. The meeting covered, health and safety issues, service users issues, new risk assessments, budget information, staff communication and how it could be improved, training and new information. The meeting was well attended and staff contributed to the discussion. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 The management arrangements within the home ensure that service users needs continue to be met and creates a homely atmosphere in which service users feel valued and supported. EVIDENCE: Staff and service users both reported to the inspector that they liked and felt that the new acting manager had “done a good job” managing the service in the absence of the existing manager who was seconded to another home. The acting manager has recruited to the vacant posts and hopes the home will be fully staffed by the end of January to the middle of February and this would make a big difference, as there would be a lot less reliance on agency staff cover. The inspector was informed that the existing manager hopes to be back in post at Cambridge Road by the end of March and at the same time the deputy manager will be returning to work. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 22 The acting manager and staff have been actively supporting service users through the recent death of one of the service users. Counselling is now being offered to service users and staff if they feel they need the extra support. The home has a range of policies and procedures produced by Choice Support and staff are requested to read and sign all policies and procedures. This was covered in the staff meeting held on the day of the inspection. A variety of records were seen during the inspection, which include fire safety records, maintenance and insurance certificates, food records, medication administration records, complaint details. These were found to be appropriately stored, well maintained and up to date. The home is a safe place for service users, visitors and staff. Health and safety checks are carried out on a regular basis. Care staff are given mandatory training across the year. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 3 X 3 X 3 X X 3 X 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 24 No 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. 1. Standard YA23 YA36 Regulation 13 (6) 18 (2) Requirement The registered manager must ensure that all staff are aware of adult protection procedures The registered manager must ensure that an annual appraisal system for staff is implemented into the home Timescale for action 30/04/06 30/04/06 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 YA13 Good Practice Recommendations For the manager to investigate ways in which a dedicated vehicle could be provided to assist service users whose mobility is decreasing and to enable easier access to community facilities outside the local area. 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 53 Cambridge Road DS0000059160.V276014.R01.S.doc Version 5.1 Page 26 - 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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