Inspection on 06/09/05 for 53 Cambridge Road

This inspection was carried out on 6th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also 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 03/01/06

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 Ian Craig Unannounced 6 September 2005 th 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. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 53 Cambridge Road Address Portswood, Southampton, Hampshire, SO14 6UT 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) 023 8055 1551 Choice Support Mr David Minett Care Home 6 Category(ies) of Learning Disability (6) registration, with number of places 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Service users may only be admitted between the ages of 18 and 65 years of age. Date of last inspection 24th March 2005 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 are now the registered providers. Cambridge Road is situated in Portswood, Southampton close to local amenities and has good transport links. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection of 53 Cambridge Road took place on 06 September 2005 by two inspectors from the Commission of Social Care Inspection. They were assisted by support staff and later joined by Mr David Minett the manager of the home. Discussions were held with a number of residents and staff. 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? Some progress has been made to meet the requirements from the last unannounced inspection. Enhanced Criminal Records Bureau certificates are now on all staff files and staff are beginning to receive training on person centred planning. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 standard(s) 2, 3 and 4. Prospective residents are assessed through the care management process and by the home prior to being offered a placement to ensure the home can meet their needs. Residents and their family have an opportunity to visit the home and meet the staff and residents before deciding to move in. EVIDENCE: The home receives referrals from care managers. The most recent admission was nine months ago. Alongside the care management assessment, the home completes a personal profile assessment which includes information about the social, health, communication and personal care needs of the individual as well as aspects about the persons life which are important to them, for example important dates that need to be remembered. Three resident files were seen. The newest resident was spoken to and confirmed that he had visited the home on a number of occasions prior to his admission. The resident also confirmed that he had a review with his social worker six months after he was admitted into the home, and that he was able to visit the home before deciding whether or not to move in. This involved joining the other residents for meals. The new resident said that he liked his new home. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 standard(s) 6 and 9. There are comprehensive care plans for each individual, which showed evidence of being regularly reviewed and updated. However, some of the information in the care plans were not detailed enough to ensure staff were meeting individual needs. Person centred planning is being introduced to the service and some training for staff has taken place. EVIDENCE: Three residents care plans were seen. Each resident has a care planning file containing comprehensive information which includes for example a basic information sheet, personal profile risk/vulnerability assessment, service delivery plan, personal support plan, practitioner visit report. Personal care plans also included guidance for managing difficult behaviour. Residents spoken to are aware of the level of staff support that they need for specific activities such as going out. The files contained records of service delivery planning meetings and six weekly reviews. Some information contained in the care plans was not detailed enough for staff to be able to meet service users needs, particularly in the section for risk management. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 10 Residents spoken to were aware of their care plans and meetings that they have with their link/keyworker. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 standard(s) 11,12,13,14,15 and 17. Although the home strives to provide meaningful social and educational activities for residents it is failing to provide the level of activities required to meet the expectations of service users social, cultural and recreational interests. Residents are able to have a choice of meals that is varied and nutritious. EVIDENCE: The home receives a day service budget of approximately £45.00 for each service user per month. This is in addition to the weekly fee. Each resident is entitled to 7.5 hours of day service each week. A separate activity plan has been developed detailing the activities for each service user and this was seen by the inspectors. Activities include one resident attending a local authority day service, trips out shopping; one service user visits a friend. Trips out are hampered by the shortage of staff and the fact that the home no longer has a dedicated vehicle. The vehicle belonged to the previous provider and was not stipulated in the new contract to remain at the home. The home mainly relies on public transport, but the inspectors were told that some residents do not like travelling on public transport. Only one member of 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 12 staff is able to use their own car and currently this is off the road. Therefore trips out are mainly limited to the local area. Staff said that trips further a field do not happen very often. One resident said that she had a recent holiday for one night in Bognor Regis with a friend. Two residents said that they would like more trips out. One resident said that in his previous home he had a programme of activities but at this home he has no trips out, day care or work and that he really would like to work. Other residents spoken to said that they would like to go to college and have a holiday. One carer has been critical of the decision to discontinue the car provision. Previously a number of residents attended a further education college for courses such as art, cookery and computers. However, due to an administration error none of the service users are able to attend the courses that they wanted as they are now already full. The staff are actively pursuing other college courses but are hampered by the lack of transport available for people to attend. The home needs to review the homes transport needs and have suitable transport available to residents to meet their particular needs Although the home has previously arranged holidays for residents, holidays for this year have not taken place. The reasons for this are unclear, but the manager is aware that the company are writing a policy on holidays and funding is an issue. Residents said that they would like to have a holiday. Relationships with family and friends are supported and maintained by the home. Examples were given of a relative spending Christmas day at the home to be with her sister. One service user regularly visits a friend by taxi. The menu was displayed on the kitchen fridge and appeared varied and nutritious. Alternatives to the main meals were also highlighted on the menu. The food shopping had been done on the day of the inspection and included fresh fruit and vegetables. During the inspection residents were seen helping themselves to drinks and sitting in the garden. Residents are involved in setting the menu. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 standard(s) 19. The healthcare needs of residents are recorded in care plans with specialist advice from the Specialist Health Care Team accessed where required. EVIDENCE: Each resident has a healthcare profile in his or her care planning file. The healthcare profile identifies support needs and guidance for staff in how to meet those needs. Practitioner reports are completed when a resident visits their GP or healthcare professional and these were viewed on file. Staff stated that they support residents to access healthcare including dentist, doctors, optician and make referrals to specialist healthcare team. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: The standards were not assessed on this occasion. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 26. The home provides a safe and suitably maintained accomodation. Residents rooms that were viewed provided appropriate equipment to meet their needs. The home is clean and tidy. EVIDENCE: The physical environment was not inspected in any detail on this occasion and will be looked at in greater depth at the next inspection. The home appeared clean and tidy. Two bedrooms were seen, both bedrooms were individually decorated to the residents choice. Bedrooms were seen to contain personal items and home entertainment systems. A resident confirmed that she chose the colour scheme for her bedroom. Residents spoken to said that they liked their bedrooms. One resident said “I have a large bedroom”. The home has an attractive rear garden. Residents described how they use the garden and that the staff and residents grow vegetables. The inspector observed residents making use of the tables and chairs on the patio and two residents described how barbecues are held during the summer. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 16 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) 32, 33 and 34. The recruitment of staff for the home is organised through Choice Support area office. Copies of recruitment records are kept in the home. The home continues to have a number of staff vacancies and is running with a shortfall of 202 hours a week. Agency staff are making up the shortfall. However, the lack of permanent staff makes consistency of care difficult and puts an added strain on the permanent members of staff. EVIDENCE: The manager reported that the company manage the recruitment process of staff for the home and that interviews have been arranged for care staff on 9th September but this is a general recruitment and not specific for the home. The situation with regard to the number of staff vacancies will be looked at the next inspection. All staff employment records were looked at and were found to contain enhanced criminal record certificates and the necessary employment records, as well as copies of birth certificates, driving licence and supervision records. The home should have a staff compliment of 13.2 full time staff. Currently the home has five full time staff. One member of staff is on maternity leave and 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 17 one member of staff is on long-term sick leave. The company have only recruited one member of staff for the home in the last 18 months. Although agency staff are used and the home strives to have the same agency staff working it does have an effect on consistency and the ability to access the community. Staff reported that they are also working extra hours in order to support residents’ needs. The staff rota was examined and this showed that at least two care staff were on duty at any given time. The total care staff hours for the week commencing 5th. September 2005 was 320.5. The Department of Health Residential Forum Guidance advises the provision of 231.71 care staff hours for 6 residents with a medium level of need. One agency member of staff spoken with said that they had had an induction into the home. The agency member of staff said that they felt it was a good home compared with some others. The inspector noted that residents appeared confident in approaching the agency member staff. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 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 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) EVIDENCE: The standards were not assessed on this occasion. 53 Cambridge Road H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 3 3 x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 3 2 2 2 3 x 3 Standard No 31 32 33 34 35 36 Score x 2 1 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 53 Cambridge Road Score 3 x x x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 20 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 YA12 Regulation 16 Requirement Residents must have access to day care and educatinal opportunities of their choice (Previous timescale of 31/05/05 not met) Staff vacancies must be recruited to so that bank and agency use is reduced. (Previous timescale of 30/09/05 not met) Arrangements must be made for residents to have access to the community, leisure activities etc. by the use of suitable transport. Timescale for action 31st October 2005 30th. September 2005 30th. September 2005 2. YA33 18 3. 14 12 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 YA13 YA14 Good Practice Recommendations The home should provide a vehicle to enable service users to make full use of leisure and opportunities. Residents should be given the opportunity as part of their basic contract the option of a minimum seven-day annual holiday outside of the home, which they help choose and plan. H55-H03 S59160 53 Cambridge Road V220743 070905 stage 1.doc Version 1.40 Page 21 53 Cambridge Road Commission for Social Care Inspection Address 1 Address 2 Address 3 Address 4 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. 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