Inspection on 13/10/05 for 62 Wright Street

This inspection was carried out on 13th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

62 Wright Street 17/04/07

62 Wright Street 02/03/06

62 Wright Street 16/03/05

62 Wright Street 12/08/04

62 Wright Street 17/03/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 62 Wright Street Mencap Homes Foundation 62 Wright Street Horwich Bolton Lancashire BL6 7HY Lead Inspector Lucy Burgess Unannounced Inspection 13th October 2005 09:30 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 62 Wright Street Address 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) Mencap Homes Foundation 62 Wright Street Horwich Bolton Lancashire BL6 7HY 01204 694286 Royal Mencap (Housing & Support Services) Ms Janice King Care Home 4 Category(ies) of Learning disability (4) registration, with number of places 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 16th March 2005 Brief Description of the Service: 62 Wright Street is a domestic property providing support and accommodation for up to 4 people with a learning disability, each have complex and multiple disabilities. Staffing is provided throughout the day and night. The property provides 4 single bedrooms, living and dining rooms and kitchen. The home is internally connected to the bungalow next door. Additional aids and adaptations are provided throughout the home to meet the needs of the service users. The home is situated close to Horwich town centre and has good access to local shops and bus routes. There is a small front and back garden, mainly paved. Parking is available on the street. The home also has its own vehicle. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and took place during one day for a period of 3½ hours. The inspector took the opportunity to look round the home, view records as well as talk with staff and observe interactions with residents. Discussion and feedback was also held with the Manager. The home is registered to provide accommodation for up to 4 people with learning disabilities. What the service does well: What has improved since the last inspection? Management had made good progress in ensuring that those things, which needed improving from the last inspection have been done, these included care plans, the environment and training information. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 6 Although all of the building was not looked at in detail during this visit, it was noted that some areas of the home had been redecorated, which enhanced the appearance. Further improvements have also been planned. 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. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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): NONE EVIDENCE: The key standard will be assessed at the next inspection. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 to 10 Residents care plans and assessments clearly identify their support needs and how these are to be met ensuring their health and well-being is maintained. Although residents are limited in their ability to verbally express themselves, individuals appeared well cared for and are encouraged to reach their potential. EVIDENCE: Care plans are in place for each of the residents. Information includes background information, personal details, communication, behaviour, emotional needs, and health and safety, routines, personal care and risk assessments. Care plans are person centred and specific to the individual needs of each resident. Risk assessments are completed on all areas identified following the initial assessment and resettlement process as well as during the course of the placement. Risks areas that have been assessed include activities both within and outside of the home and identify support requirements, these include moving and handling, bathing, wheelchairs, epilepsy, using the vehicle and equipment and activities. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 10 As most of the residents are unable to verbally express their wishes, staff will observe their responses, which indicate their preferences. Staff have a good understanding with regards to the gestures and non-verbal communication used by the residents. Close observation is essential in this process. Information is detailed within the person centred plans. Information with regards to residents’ finances was not examined at this inspection this will be addressed in detail at the next inspection. Each of the residents are fully supported with the management of their finances. Appropriate appointees are in place and records are kept of all transactions and monitored on a monthly basis. Due to the complex needs of the service users, involvement in the day-to-day running of the home and policy development is not undertaken. Staff will advocate on behalf of the residents and consideration is given when recruiting new members to the team, ensuring skills and experience meets the needs of the residents. The home has an intercom system, which is provided in each of the residents’ bedrooms. This is used during the night shifts and risks have been assessed taking privacy into consideration. The home also has an on-call system in place, which offers support throughout the day and night. An on-call manager is also available should additional advice or assistance be required. The home continues to hold information regarding residents securely, whilst being accessible to staff. Staff are aware that when information is given to them in confidence this may be shared with the relevant professionals. Information regarding confidentiality is also discussed as part of the homes induction programme along with organisational policies and procedures. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 to 17 Each of the residents choose how they wish to spend their time both in and away form the home. Individual’s access places within the community, enabling them to increase their independence. Full support is offered. Residents continue to maintain contact with family. This is encouraged so that residents benefit from other relationships and friendships. The dietary needs of the residents and closely monitored ensuring their health and nutrition is maintained. EVIDENCE: As stated earlier individuals who reside at Wright Street have complex disabilities with limited or no verbal communication therefore rely on staff support to develop new skills or join in activities. Within the residents’ individual plans, activities and routines have been identified and are flexible due to individual needs. One of the residents still attends a local day centre however this is to cease at the end of year. The staff team will then provide alternative daily activities. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 12 Each of the residents are also involved with numerous activities both in and away from the home. These include swimming, hydro-therapy, cinema, theatre trips, football, ramble clubs, activity centres, shops and hairdressers. Due to restrictions in their mobility residents are fully supported by staff. The home also has access to a vehicle, which enables residents to access the wider community. Relationships with family and friends are encouraged and maintained. Due to their complex needs regular support is available from physiotherapists, occupational therapists and the nursing team when required. Additional aids are accessed to assist in maintaining the health and well-being of residents. The home continues to explore suitable holiday opportunities however due to the high level of physical needs and aids required in meeting the needs of the residents this has been difficult to arrange, therefore a variety of day trips have taken place enabling individual to access the wider communities, these have included Southport, Knowsley, Blackpool lights, the Lake District and Botany Bay. One of the resident has arranged to go to Wales for a few days with staff and would also be visiting relatives who also live in the area. The inspector spent time speaking with members of the staff team. It was felt that staff have a sound understanding in relation to the abilities of each resident as well as the types of leisure activities appropriate to their needs and preferences. The staffing at the house is such that each person is able to pursue their individual activities and interests as additional staffing would be provided to facilitate this. One of the residents is feed through a peg. Training has been undertaken by the majority of the team in relation to peg feeds, further training will be planned with the visiting nurse to assess competence for the newest members of the team. Recording and monitoring sheets are completed each day. Another resident requires a soft diet, food is processed and appropriately served. The residents’ nutritional needs are closely observed and regularly reviewed. Residents also enjoy meals out. Mealtimes are relaxed unhurried and flexible. Alternative arrangements are being sought in relation to facilities where residents can be weighed regularly as part of their health care monitoring. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 to 20 Residents health and personal care needs are consistently met ensuring their well-being is maintained. Specialist health services are also accessed to promote the health needs of residents. A safe system of medication administration was found ensuring residents are protected and practice is safe. EVIDENCE: As already identified each of the residents have complex needs therefore staff provide full support in meeting their personal care needs. Bedrooms and bathrooms have been fitted with ceiling tracking hoists and assisted bathing in order for appropriate care to be provided. Levels of support are recorded on individual care plans. The staff team consists of both male and female support therefore where possible same gender support is provided. Information in relation to health monitoring and professional input is documented within an individual health action plan. This information clearly identifies the individual medical histories, medication requirements, input from health professionals and dietary needs. Information provides staff with detailed information about the needs of residents and the level of support or intervention required ensuring their needs are fully met. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 14 As previously identified each of the residents have access to healthcare facilities and specialist professionals. Staff continue to monitor their health closely and access advice and support in relation to any health problems as well as accessing additional aids, which provide further support and comfort for the residents. Each of the residents continues to be registered with a local GP. Access to other community health care provisions such as chiropody, dentist, hearing test, district nurse, and incontinence advise, physiotherapy and epilepsy clinic are accessed as and when required. Visits from medical/healthcare practitioners can take place in private. Specialist beds and mattresses are provided with regards to the prevention of pressure sores as well as ensuring residents are comfortable. One resident has additional aids to assist in improving his posture these include a splint for his leg and a standing frame. Whilst another residents has accessed a new wheelchair, which provides more comfort and support. Residents are accompanied by staff to appointments. The management of medication continues to be undertaken by the staff team. Relevant training is undertaken by all staff prior to them undertaking any support with medication needs. Further training has been completed with the local authority and nursing team in relation to peg feeds and medication and PRN epilepsy medication required by individuals who live at the home. The home continues to have medication supplied by BOOTS pharmacy using the monitored dosage system. A recent audit has been undertaken by the supplying pharmacist, a copy of the report has been requested by CSCI. Clear policies and procedures are held by the home. On examination of the medication a safe system of storing and recording of medication was seen to be in place. Detailed information is recorded with regards to the service user current medication as well as a pen picture and medical/health history. Medication is reviewed regularly with health professionals. Rising and retiring times are flexible, depending on their individual routines. During the visit the morning routine was very relaxed with residents rising later in the morning. Residents spend time relaxing in the lounge or in their own rooms. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 and 23 Systems are in place with regards to the investigation of complaints and adult protection issues along with relevant training, ensuring that residents are listened to and protected. EVIDENCE: Clear policies and procedures are in place covering these standards. A copy of the Local Authorities Vulnerable Adults procedure has been accessed. The team are aware of the procedure to follow and training has been completed. Appropriate recording systems are in place should any concerns or complaints be raised. No complaints have been raised with the CSCI or the home. The home also has further written policies and procedures for adult protection. These include dealing with whistle blowing, aggression, service users finances and missing persons. All staff have a Criminal Record Check in place. Information regarding the residents’ finances was not seen during this visit however will be examined at the next inspection. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 Wright Street provides a comfortable homely environment for those that live there. Further redecoration and refurbishment is taking place, this will further enhance the home. EVIDENCE: Wright Street is registered for 4 people and at present is fully occupied. The home is a purpose built bungalow. The home is in keeping with the local community and is accessible to all local amenities and facilities. Communal areas comprise of a lounge, large open dining room and kitchen. There is also an office available with sleep in facilities for staff. The environment is domestic in scale, accessible, clean, and homely. The home is internally connected to the bungalow next door. There is a small front and back garden, mainly paved and parking is available on the street. Each of the residents have a single bedroom, which has been decorated and personalised to their choosing. Some of the rooms have also been fitted with ceiling-tracking hoist in order for staff to provide the appropriate support in meeting the needs of the service users. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 17 Some redecoration has taken place to the hallway and dining room including new carpets. Further work is to be carried out with a new kitchen being fitted and the redecoration of the lounge. Irwell Valley Housing Association, the landlords, have also agreed to replace glass within the internal door ensuring the safety of staff and residents. The home provides one bath and one shower room with aids to offer assistance. Separate toilet provisions are also available and there is a sink in each of the bedrooms. An assisted bath, which rises and falls has been fitted providing comfortable facilities for the service users and easy for staff when moving and handling. The bathroom has also been fitted with a ceilingtracking hoist. Work is still needed to the bathroom and toilet flooring. Correspondence from Irwell Valley dating back to June 2005 stated that this would be dealt with as a ‘matter of urgency’ however this has yet to be addressed. This is unsatisfactory and is being followed up by the home’s manager. Each of the residents continue to have the provision of a monitoring system for night times. This is to ensure that health needs are monitored. Information is recorded on the individual service user files. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 18 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, 34 and 35 Staff at the home are in sufficient numbers to meet the needs of residents. Recruitment and selection procedures are thorough ensuring that the residents are protected. Continuous training is undertaken by all members of the team ensuring staff have the knowledge and skills needed in meeting the needs of residents. EVIDENCE: Mencap have rigorous recruitment and selection procedures, which are followed when employing new staff. The recruitment process involves staff with various management responsibilities and residents. Since the last inspection there have been three new staff employed at the home. All were seen to have previous care experience and have previously undertaken training relevant to care work. Information held in relation to their recruitment as well as the criminal record check had been carried prior to their employment commencing therefore ensuring the safety and protection of the residents. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 19 The staff team at Wright Street comprises of 12 support staff excluding the Manager. Eight members of the team have completed the NVQ Level 2. Four further members of the team are currently working through the course or have just commenced the training. Several members of the team have also progressed to the Level 3. Those wishing to progress to level 3 are encouraged to so with time being provided to complete the course. The Registered Manager has completed the Registered Managers Award and has just completed the Level 4 care modules. This has yet to be verified. She also hold the Assessors qualification. A copy of the Registered Managers certificate should be forwarded to the CSCI. Regular training has been provided for the staff team. This has included LDAF Induction and foundation training for the newest members of the team as well as courses in Total Communications, Vulnerable Adults, Epilepsy, Support Workers Day, Peg, Risk Assessments, Budget Awareness, Medication, Person Centred Planning as well as mandatory courses. Those staff that have yet to complete some of the courses will be scheduled to do so later in the year. Information in relation to courses completed and dates for refreshers are held on individual files along with copies of the certificates. From discussion with staff and the manager, feedback was very positive in relation to the level of management support offered. Individuals were enthusiastic and appear to take pride in the support they provide. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 20 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): NONE EVIDENCE: The key standards will be assessed at the next inspection. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 3 12 3 13 4 14 4 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 62 Wright Street Score 4 4 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000009317.V256672.R01.S.doc Version 5.0 Page 22 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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 YA20 YA35 Good Practice Recommendations That a copy of the recent pharmacy inspection report is forwarded to CSCI That a copy of the certificate for the Registered Managers Award is forwarded to the CSCI. 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 62 Wright Street DS0000009317.V256672.R01.S.doc Version 5.0 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. 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