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Inspection on 17/01/06 for 59 Whitehorse Road

Also see our care home review for 59 Whitehorse Road for more information

This inspection was carried out on 17th January 2006.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a very friendly and relaxed atmosphere at this home. Throughout the inspection service users appeared happy and content. Staff that the inspector spoke to confirmed the importance of building good relationships with service users, for example one person stated, "we have a laugh but at the same time let service users know they can talk to us if they have a problem". Staff at the home are also good at promoting service users privacy and dignity. The inspector witnessed staff knocking on bedroom doors and asking service users their opinion when offering support. Service users that the inspector spoke to reinforced these practices as the norm. As one service user stated, "the staff are lovely".

What has improved since the last inspection?

Since the last inspection the home has addressed all but 3 requirements from previous visits. These include introducing person centred plans for service users, fitting an electric bath chair as recommended by the occupational therapist, completing initial health check assessments for service users and providing adult protection and challenging behaviour training for staff. In addition to this all staff are now in the process of completing learning disability award framework accredited training and all requirements relating to maintenance of the building have also been actioned.

What the care home could do better:

The home must review all service users risk assessments and ensure they contain detailed information in order that risk can be reduced. In addition to this risk assessments must be based one each persons capabilities and linked to needs identified in plans of care. This will ensure a more holistic approach to care planning takes place. Some improvements to infection control and health and safety practices are also required such as providing training, information and the introduction of risk assessments for cleaning products. Further development of the quality assurance system is required with the views of service users and other interested parties forming the basis of this monitoring tool.

CARE HOME ADULTS 18-65 Whitehorse Road, 59 59 Whitehorse Road Brownhills Walsall West Midlands WS8 7PE Lead Inspector Lesley Webb Unannounced Inspection 17th January 2006 08:30 Whitehorse Road, 59 DS0000038819.V278254.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 Whitehorse Road, 59 DS0000038819.V278254.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. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Whitehorse Road, 59 Address 59 Whitehorse Road Brownhills Walsall West Midlands WS8 7PE 01543 361478 01543 361478 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) Mrs Jacqueline Anne Bernard Dorothy Jones Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 June 2005. Brief Description of the Service: 59 Whitehorse Road provides residential accommodation and personal care for up to six younger adults with learning disabilities. The home is located on the outskirts of Brownhills close to Cannock Chase, a public house and local shops. All bedrooms are single occupancy; there is a large lounge, dining area, well equipped kitchen and separate laundry facilities. No bedrooms have en-suite facilities. It is a single storey building with parking to the front and a large patio area to the rear. The home has ramps and grab rails making it easily accessible. The home also provides its own transport. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector arrived unannounced at 8.30am and stayed until 1.30pm. Time was spent talking to service users, observing care practices, talking to staff and looking at records before giving feedback about the visit to the manager. As this is the second inspection to take place in twelve months both this report and the one published in June 2005 should be read when looking at national minimum standards that the home is achieving. By the end of the visit the inspector was satisfied that generally the home offers a good service and would like to thank both service users and staff for their co-operation and assistance during time spent at the home. What the service does well: What has improved since the last inspection? Since the last inspection the home has addressed all but 3 requirements from previous visits. These include introducing person centred plans for service users, fitting an electric bath chair as recommended by the occupational therapist, completing initial health check assessments for service users and providing adult protection and challenging behaviour training for staff. In addition to this all staff are now in the process of completing learning disability award framework accredited training and all requirements relating to maintenance of the building have also been actioned. Whitehorse Road, 59 DS0000038819.V278254.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. Whitehorse Road, 59 DS0000038819.V278254.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 Whitehorse Road, 59 DS0000038819.V278254.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): Standards assessed at previous inspection. EVIDENCE: Whitehorse Road, 59 DS0000038819.V278254.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): 6 and 9. Care planning is good, providing staff with the information they need to satisfactorily meet service users needs. Assessments of risk are basic. Improvements will offer greater protection to service users. EVIDENCE: Since the last inspection the home has introduced essential lifestyle plans (a form of person centred planning) for all service users that have been completed with service users, staff and other interested parties (meeting requirements and recommendations identified in previous inspections. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 10 All service users files sampled contained individual risk assessments that are reviewed at least every six months. However upon greater inspection of these documents it was found that the assessments do not always correspond with needs identified within plans of care. The inspector also found that some risk assessments were basic in terms of content and context and do not demonstrate levels of risk based on each persons individual capabilities. When talking to staff they demonstrated knowledge of supporting service users with regards to risk taking. For example one person stated, “we try to encourage independence but have to manage the risks at the same time. For instance one service user is able to make a cup of tea but needs supervision with the hot water”. Whitehorse Road, 59 DS0000038819.V278254.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. Generally practices within the home demonstrate that service users are encouraged where possible to exercise choice and control over their lives. EVIDENCE: The home operates weekly routine planners for each service user in order to monitor choices and freedom of movement. The inspector witnessed staff knocking on bedroom doors before entering to ensure privacy and respecting individuals needs to be alone. All service users bedroom doors are lockable with over-ride safety devices. No service user has a key to the front door of the home, however risk assessments have been implemented relating to this practice. Files sampled by the inspector found parental consent for staff to open service user mail on their behalf. Service users responsibilities for housekeeping tasks were documented in care plans sampled and incorporated into contracts/terms and conditions. Staff demonstrated knowledge and awareness of service users rights and responsibilities to lead as ordinary life as possible. For example one person stated, “ people should always have the right to make choices, maintain links with families, go to work, shopping for own items, try to make life like our own”. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 12 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): 19. Generally the health needs of service users are well met, with evidence of good multi disciplinary working taking place. EVIDENCE: It was noted by the inspector that a previous requirement to address recommendations by the occupational therapist has now been met, with equipment provided in the bathroom to aid personal care. Staff at the home are still however awaiting accredited medication training but the manager states this is being arranged through a local college, so should be actioned when the next inspection takes place. Since the last inspection initial health check assessments have been completed for all service users in order that appropriate monitoring of needs takes place. Records sampled by the inspector demonstrate that service users receive healthcare checks for medication, chiropody, dentists and opticians. As one service user explained to the inspector, “when your ill the staff get you better. They call the doctor, help you, and sort you out”. Only one service users records confirmed that hearing tests occur. The manager stated that this is completed for all service users at the daycentres they attend. The inspector explained that if this is the case the home must be able to evidence this within its records. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 13 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): Standards assessed at previous inspection. EVIDENCE: It was noted by the inspector that since the last inspection all staff have undertaken adult protection training (this addresses a previous requirement). Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 14 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 and 30. The standard of the environment within this home is good, providing service users with a comfortable place to live. Infection control measures require improving to ensure staff and service users are not placed at risk. EVIDENCE: All 6 requirements relating to the environment identified in the previous inspection have been met. Woodwork around the outside of the building has been attended to, debris in the garden removed, carpet replaced and paintwork redecorated. Although the home completes fire safety monitoring itself the fire department has not inspected the building since 2000. The inspector recognises that inspections are completed on a risk-assessed basis but instructed the home to contact the department to seek clarification with regards to if an inspection is required. The home has a separate laundry room with washing, drying and sluicing facilities. At present there is no hand washing sink, paper towels or liquid soap in this room, with staff having to use the adjacent toilet. The inspector was informed that the laundry would be refurbished when building work commences to increase bed spaces at the home and these issues will be Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 15 addressed. Written policies and procedures are in place for the control of infection that includes the safe handling and disposal of waste, dealing with spillages, provision of protective clothing and hand washing. The inspector instructed that the home must be able to demonstrate that staff read these policies and understand the contents. Upon inspection of protective equipment available in the laundry the inspector found that two types of disposable gloves were in use, one of which are not recommended by department of health when dealing with bodily fluids. This was discussed with the manager who removed them immediately. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 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 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. Generally the training and development of staff in this home is good, ensuring staff are adequately skilled to care for the people living there. EVIDENCE: Previous requirements for staff to undertake behaviour modification and national vocation qualifications have been met in full. In addition to this evidence was supplied that demonstrates all staff are in the process of completing learning disability award framework accredited training. Although there is no training and development plan for the home or individual assessments for staff the inspector could find no evidence of this having a detrimental effect on training provision for staff. All records viewed demonstrate that the manager monitors training needs and that staff are suitably qualified. Of the 9 staff working at the home 3 hold national vocational qualifications and the remaining 6 are in the process of completing. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 17 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): 39 and 42. Although the home monitors the quality of service provision this is not based on the views of service users and/or their representatives. This detracts from its value. Further work is required to ensure that all practices within the home promote and safeguard the health, safety and welfare of people living and working there. EVIDENCE: Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 18 The home has a good quality assurance system that it has devised itself based on the needs of the home and service provided. Records demonstrated that most areas of Standard 39 are being met, with regular evaluation taking place by the manager that linked the development of the service to the needs of the service users. The inspector instructed that the results of the service user surveys, family questionnaires and views of stakeholders must form part of the quality assurance system and annual audit, with the findings made available to interested parties including the Commission for Social Care Inspection. Practices and records demonstrated that the manager attempts to ensure the health and safety of service users and staff at all times, within the realms of her responsibilities. Written evidence verifies that gas, electrical wiring, equipment and water services are maintained appropriately and within the approved timescales. External contractors complete analysis of the water for compliance with Legionella along with the home carrying out its own monthly water temperature checks. COSHH data sheets were found to be in place for products used within the home but no risk assessments. The inspector instructed that this must be addressed and also recommends that data sheets be located in the same rooms where products are stored and/or used for ease of reference (at present these are kept in the office). An abundance of other risk assessments were found to be in place for all other safe working practices apart from the practice of unqualified staff administering medication. Training records confirm that staff hold up to date certificates for first aid, moving and handling, food hygiene and fire safety. The manager and deputy hold infection control certificates with all other staff requiring this qualification. The inspector also instructed that anyone involved in the compilation of risk assessments must be suitably qualified. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 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 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 X 23 X ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 2 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 X 2 2 X X X 2 X X 2 X Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 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 YA9 Regulation 13(4) Requirement Comprehensive risk assessments must be completed for all service users based in their individual capabilities. Risk assessments must be completed for any identified needs contained with plans of care. A record of healthcare appointments completed at daycentres must be maintained on service users files. All service users must have the opportunity to access hearing tests. All staff that administer medication must undertake accredited medication training Requirement originally made September 2003. The home must contact West Midlands Fire Service with regards to completing an inspection of the premises. A hand washing sink, paper towels and liquid soap must be provided in the laundry. Timescale for action 30/03/06 2 YA19 12(1) 30/01/06 3 YA20 13(2) 30/03/06 4 YA24 16(1) 30/01/06 5 YA30 13(3) 30/03/06 Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 21 Correct personal protective equipment must be provided when dealing with bodily fluids. The home must be able to demonstrate that staff read infection control policies and procedures. The home must be able to demonstrate that staff use Learning Disability Award Framework accredited training – Part met. Requirement originally made September 2004. The registered manager must receive regular supervision with written records maintained and available for inspection – Part met. Requirement originally made September 2004. The views of service users, families and stakeholders must be included in the annual audit of the quality assurance system. Risk assessments must be completed for all products covered by the Control of Substances Hazardous to Health regulations. 6 YA35 18(1) 30/03/06 7 YA36 18(2) 30/03/06 8 YA39 24 30/03/06 9 YA42 13 28/02/06 10 YA42 13 A risk assessment must be completed for the practice of unqualified staff administering medication. All staff must undertake infection 30/03/06 control training. Anyone involved in the compilation of risk assessments must be suitably qualified. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 22 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 YA42 Good Practice Recommendations It is recommended that COSHH data sheets be stored in the same location where products are in use. Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA 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 Whitehorse Road, 59 DS0000038819.V278254.R01.S.doc Version 5.1 Page 24 - 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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