Inspection on 30/01/06 for 6 Queensview Crescent

This inspection was carried out on 30th 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 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

6 Queensview Crescent 14/07/08

6 Queensview Crescent 18/03/08

6 Queensview Crescent 04/01/07

6 Queensview Crescent 23/09/05

6 Queensview Crescent 29/03/05

6 Queensview Crescent 22/09/04

6 Queensview Crescent 12/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

Pennine Camphill

Muston Road (70)

Grayling

The Cornerstone

John Street Nursing Home

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

CARE HOME ADULTS 18-65 6 Queensview Crescent Warley Road Scunthorpe North Lincolnshire DN16 1QN Lead Inspector Ms Matun Wawryk Unannounced Inspection 30th January 2006 11:00 6 Queensview Crescent DS0000002872.V264088.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 6 Queensview Crescent DS0000002872.V264088.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. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 6 Queensview Crescent Address Warley Road Scunthorpe North Lincolnshire DN16 1QN 01724 270407 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) None New Era Housing Association Limited Undergoing Registration Process Care Home 6 Category(ies) of Learning disability (6), Physical disability (3) registration, with number of places 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd September 2005 Brief Description of the Service: 6 Queensview Crescent is a care home providing personal care and accommodation for six adults aged 18-65 years with learning difficulties. The care home is owned by New Era Housing and Support and is situated close to two other homes owned by that company. The home is located in a residential area close to the centre of Scunthorpe. It is close to local shops, amenities and public transport. The home is a purpose built bungalow. All the bedrooms are single; bedrooms are fitted with wash hand basins. Bedrooms are decorated and furnished to meet individual service users requirements and preferences. Communal areas of the home are decorated and furnished in a domestic style. Aids and adaptations are provided as required to meet service users’ needs. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced took place on the 30th January 2006 and lasted for four hours. Most of the service users in the home on the day of the inspection had very limited verbal communication skills and the inspector spent time with service users observing activities instead of conducting formal interviews. The inspector spoke to the manager and two members of staff who were working in the home at the time of the inspection. A tour of the home also took place and a number of service user, training, recruitment and selection and medication records were examined. What the service does well: What has improved since the last inspection? The home had made for progress in developing essential life plans for most of the service users. These will be used as a foundation to develop more 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 6 individualised risk assessments and support plans, thereby promoting a more person-centred approach to service delivery arrangements. 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. 6 Queensview Crescent DS0000002872.V264088.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 6 Queensview Crescent DS0000002872.V264088.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): There had been no new admissions to the home; therefore none of these standards were assessed on this occasion. EVIDENCE: 6 Queensview Crescent DS0000002872.V264088.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, 7 & 9 Generally individual care programmes are comprehensive and reflect all the service users’ identified needs. Care programmes need to be produced in a different format to improve the accessibility of these for service users. EVIDENCE: 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 10 The inspector examined a sample of two individual service user care records. There was evidence that care plans and risk assessments had been developed from the single care management care plan. The individual plans for one service user were very detailed and service user focused. This means staff have access to all the information they need to care for the service user properly. Records and discussions with staff identified the support plan for one service user who suffers from epilepsy, required review and amendment in the light of a recent unexplained injury and current seizures. This is needed to ensure staff have access to all the information they need and to ensure the health and welfare of the service user. Completed risk assessments were in evidence in both files examined and these had been regularly reviewed. The home utilises a standard risk assessment format for all service users. The inspector was advised that once essential life plans have been fully completed, new risk assessments would be produced specific to the individual service user. This will promote a more person centred approach and support the delivery of more personalised care. Care programmes are currently produced in standard written format. These need to be produced in a more accessible format for service users. This remains an outstanding requirement from previous inspections and must now happen. None of the service users totally managed their own finances. New Era staff act as appointees for some service users living at the home. All service users had a financial support plan. Records and discussion with staff evidenced some service users had purchased their own beds and had also paid for staff to go on holiday with them. Financial plans did not give guidance for this. The registered person must ensure financial support plans provide a clear audit trail for decision-making. This is needed so that the home can demonstrate arrangements are in place to support effective management of the service users’ finances and to ensure appropriate safeguards are in place. 6 Queensview Crescent DS0000002872.V264088.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): 11, 12, 16 & 17 The personal development, recreational and social needs of service users are reasonably well catered for. Service users are encouraged to maintain family links and friendships. The meals in the home are good offering both choice and variety. EVIDENCE: Examination of records and discussions with staff identified service users benefited from a structured programme of activities. A number of service users attended day services provided by the local authority. In addition local authority staff attended to the home to provide individual support to some service users. Anecdotal evidence indicated some service users had had their day centre time reduced over the last two years. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 12 Staff advised the inspector that they also carried out activities with service users for example, hand massage and nail care, outings, pub visits and shopping trips etc. Staff commented that sometimes they were not always enabled to take service users as must as they would like because of current staffing levels in the home. Please also refer to comments detailed on page of this report. Records did not evidence any joint planning and recording around activity provision. Consideration should be given to this. This would promote a more consistent approach and show how activities accessed at the day centre fit in with activities provided in the home. Staff stated relatives and visitors are made welcome at any reasonable time and records seen confirmed this. Key workers helped service users to maintain family contact by sending cards at significant occasions such as birthdays and Christmas. There by helping and supporting service users to maintain family contacts and relationships. Service users are provided with three meals a day and a varied menu was available. Food likes and dislikes were recorded. The inspector spent time in the dining area observing the lunchtime meal. Staff were observed to assist service users to eat in a sensitive manner and service users were not hurried. 6 Queensview Crescent DS0000002872.V264088.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, 19 & 20 Personal support is offered in such a way as to promote and protect the service users’ privacy and dignity. Arrangements for meeting the healthcare needs of service users are generally satisfactory. The arrangements for medication need to be supported by formal medication training for staff. EVIDENCE: All the bedrooms are single occupation this means treatments and examinations can be carried out in private. Care programmes detailed how personal care should be provided. All service users were registered with a GP. A record of routine eye tests, dental and chiropody checks had been maintained and service user weights were being monitored. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 14 Records examined did not evidence that annual health checks including a review of medication and been sought and provided for all the service users living in the home. The registered person must ensure annual health checks are requested for all service users. This is needed to ensure all the health care needs of service users are identified and met. Health action plans had not been introduced into the home. The manager reported that discussions were taking place with the local authority regarding this issue. Care workers administer medication. The home uses the Nomad system for drug administration. Medication administration records checked were satisfactory. There were no controlled drugs in use in the home at the time of the inspection. Staff had not been provided with accredited medication training. Staff reported that in-house training had been provided and records seen confirmed this. The need to provide accredited training was discussed with the manager who reported that formal training was shortly to be provided. This is needed to ensure staff have the necessary skills and competencies to carry out this role safely and must now happen. 6 Queensview Crescent DS0000002872.V264088.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 The home has a satisfactory complaints procedure and complainants can be assured their complaints will be acted upon. EVIDENCE: No complaints had been made in the last twelve months. A detailed complaints procedure was in place. In discussion with the inspector staff reported understanding of the procedure and knew whom to contact to make a complaint and or to raise concerns. This means complainants can be assured their complaints will be listened to and acted upon. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 16 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, 26, 28 & 30 The home was clean and tidy. The standard of the décor within some parts of the home does the not provide service users with an attractive place to live in. EVIDENCE: The inspector carried out a tour of the home. The home was clean and tidy and no mal odours were noted. At the last inspection the inspector noted two bedrooms carpets were in need of cleaning or replacing. The sitting room carpet was marked and stained in places. The inspector was advised that all the carpets had been cleaned but this had not removed all the marks and stains. Although this does not pose a health and safety risk to service users, it does not create a pleasing and welcoming environment for service users. All bedrooms examined were clean and tidy and were furnished and decorated in a homely style. Staff had assisted many of the service users to furnish their bedrooms with a range of personal items to reflect individual choice and tastes. The rear garden is on a slope which means it is not readily accessible to service users. The need to improve the accessibility of the garden remains an outstanding requirement from previous inspections. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 17 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): 32, 33, 34, 35 & 36 Staffing levels are generally satisfactory but a review is needed to ensure the numbers of staff available reflect the dependency levels of service users. The home operates sound recruitment and selection practice. EVIDENCE: The roles and responsibilities of staff are clearly defined and understood. Staff understood the management and reporting structures for the home. Staff commented that generally staffing levels were satisfactory, however it was reported that extra staff was needed at key times. There was no evidence to show a formal review of staffing had been carried out, despite records and discussion with staff indicating the dependency levels of some service users had increased over the years. The home did not have a tool for assessing dependency levels. This is needed to ensure informed judgements can be made about the number of care hours needed to meet the needs of service users. The inspector examined the personnel file for the one new worker employed since the last inspection. All records and checks required by Regulation 19 of the Care Homes Regulations were available. This means the homes takes appropriate steps to protect service users through sound recruitment and selection practice. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 18 Training records showed staff were up to date with all areas of mandatory training. There was some evidence that some staff had had specific learning disability/service user training however this was not the case for all the staff. This needs to be an area of development to ensure staff have the necessary skills and competencies to meet the changing needs of service users. The inspector was advised that a revised induction programme for staff had been implemented within the home. New staff will complete equal opportunities training, including disability training; race equality and antiracism training as part of this programme. The registered person must ensure existing staff are provided with this training. This remains an outstanding recommendation from previous inspections There was evidence of a commitment to NVQ training. One support worker held an NVQ qualification and four others had enrolled to complete an NVQ. The registered person must continue the programme of NVQ training to ensure 50 of care workers obtain an NVQ or equivalent. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 19 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 & 43 There is currently no registered manager for the home. This means current arrangements do not meet legal requirements. The management of health and safety is satisfactory. A structured quality monitoring system must be introduced into the home. This is needed to make sure that everyone is consulted about the running of the home and to ensure continuous improvements are made. EVIDENCE: There is currently no registered manager for the home. This means current arrangements do not meet legal requirements. Staff described the current manager as efficient and approachable. Systems were in place for the manager to give and receive feedback through handovers, staff meetings, supervision and informal contacts. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 20 At the last inspection the inspector was advised that the existing manager was going to submit an application to register with the Commission. This is no longer the case. The inspector was advised that the manager’s post was going to be advertised. Once appointed, the new person will be expected to make an application to the Commission. The home had a range of mechanisms in place to monitor the quality of services provided including regular audits of the homes environment. However a specific development plan for the home was not available. The registered person must implement a quality assurance programme, which fully meets the requirements of NMS 39. This is needed to make sure that everyone is consulted about the running of the home and to ensure continuous improvements are made. This remains an outstanding requirement from previous inspections and must now happen. There were comprehensive health and safety policies in place and a health and safety statement. Safe working practices were maintained by the provision of training to staff in the form of moving and handling, basic food hygiene, first aid, COSHH and fire safety. Systems were in place to ensure that all the homes equipment was up to date. Service contracts/ certificates were in place for gas; portable electrical appliances; fixed electrical systems and water systems; fire safety equipment and moving and handling equipment. Hot water was monitored regularly and records seen during the inspection were satisfactory. The overall management of the service was found to be satisfactory. However the Commission has not received any Regulation 26 visit reports since the last inspection. The responsible individual for the home is required to produce and make available a report under Regulation 26 of the Care Homes Regulations. This is needed to show that the home is being monitored and to meet legal requirements and this must now happen. 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 21 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 x ENVIRONMENT Standard No Score 24 2 25 x 26 3 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 2 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 x 3 x LIFESTYLES Standard No Score 11 2 12 2 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 1 X 2 X X 3 2 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 22 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 YA20 Regulation 18(1) Requirement The registered person must provide all staff dealing with service users medication with accredited training. The registered person must ensure the gardens are safe, well maintained and accessible to all service users. Timescale of 16.10.03 not met 31.11.05 not met. The responsible person must develop support plans in a more accessible format for service users. Daily records should relate to the support plans. Timescale of 31.3.05 and 31/11.05 not met. The registered person must develop a quality assurance and monitoring system that meets the requirements of this standard and produce an annual development plan based on a systematic cycle of planning-action-review, reflecting aims and outcomes for service users. Timescale of 19.2.04 and 31.12.05 not met. The registered person must ensure the support plan for the DS0000002872.V264088.R01.S.doc Timescale for action 31/03/06 2. YA28 23(2o) 31/03/06 3. YA12 6 31/03/06 4. YA39 24(1a&b, 2,3) 30/04/06 5 OP7 15 14/02/06 6 Queensview Crescent Version 5.1 Page 23 6. YA37 8 7. YA24 16 8. YA33 18(1a) 9 YA19 13(1) 10 YA43 26 11 YA7 12 & 15 service user A is reviewed and updated. The registered person must ensure a manager is appointed. Once appointed the manager must submit an application to register with the Commission for Social Care Inspection. The registered person must have the sitting room carpet and the two stained bedroom carpets replaced. The registered person must develop a tool for assessing dependency levels. This should then be used to assess whether care hours provided in the home are appropriate to enable staff to meet the care and support needs of service users currently living in the home (Timescale of 31.12.05 not met. The registered person must ensure (with the agreement of the service user or their representative) an annual health check including a review of medication checks is requested. The responsible individual for the home must produce and make available a report under Regulation 26 of the Care Homes Regulations. The registered person must review the financial plans for all the service users. Levels of decision-making concerning purchases must be recorded. Plans must be agreed with the service users and/or their representatives. 30/06/06 30/04/06 31/03/06 28/02/06 28/02/06 31/03/06 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 24 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 YA14 Good Practice Recommendations The registered person should provide service users in longterm placements with the option of a minimum seven-day holiday outside the home as part of the basic contract price. The registered person should consider adopting systems, which support joint activity planning and recording for service users attending day services to promote a more coordinated approach. The registered person must provide all staff with equal opportunities training, including disability training; race equality and anti-racism. Timescale of 16.10.03 and 31.12.05 not met. The registered person should ensure that training is ongoing so that 50 of care staff in the home hold NVQ 2 or above by 2005. 2 YA13YA11 3 YA35 4 YA32 6 Queensview Crescent DS0000002872.V264088.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF 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 6 Queensview Crescent DS0000002872.V264088.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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