Inspection on 15/02/06 for 63 Junction Road

This inspection was carried out on 15th February 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

63 Junction Road 29/09/05

63 Junction Road 20/07/05

63 Junction Road 17/01/05

63 Junction Road 04/10/04

63 Junction Road 11/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Aston Court Nursing Home

Polesworth Group 70 Long Street

Breme

Ravenhurst

Polesworth Group 64 Long Street

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

CARE HOME ADULTS 18-65 63 Junction Road Leek Staffordshire ST13 5QN Lead Inspector Ms Wendy Jones Announced Inspection 15 February 2006 13:00 63 Junction Road DS0000004964.V280265.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 63 Junction Road DS0000004964.V280265.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. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 63 Junction Road Address Leek Staffordshire ST13 5QN 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) 01538 382542 Choices Housing Association Limited Mrs Sandra Aileen Perkin Care Home 5 Category(ies) of Learning disability (5), Physical disability (2) registration, with number of places 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 5 LD - 2 may be PD Date of last inspection 20th July 2005 Brief Description of the Service: 63 Junction Road is a well-maintained domestic style detached residence, which fits unobtrusively into the surrounding suburban setting on the outskirts of Leek. The home is registered to provide care for five people with medium dependency needs and who have learning disabilities requiring 24-hour care. Accommodation is provided on two floors. The first floor is accessed by a main stairway. There are two ground floor bedrooms and three on the first floor. The service is operated by Choices Housing Association, a non-profit organisation who provide care and other services throughout Staffordshire and Stoke-on-Trent. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection carried out on 15th February 2006 at 1:00pm. Information for the report was provided from the pre-inspection questionnaire; from 2 service user and 5 relative feedback forms; from discussion and interviews with staff and service users; from inspection of care records, staff rotas, recruitment records, fire safety records, medication sheets and storage; menus and the environment. At the time of the inspection the home was fully occupied with 5 service users. Dependency levels were described as medium: 2 service users had hearing and visual impairments, 2 service users required help with washing and bathing, and 1 service user had specialist communication needs. What the service does well: The service offers care and accommodation for service users with a learning disability. The age range of service users was from early twenties to early fifties. The property is a mature semi-detached property, in a residential area of the market town of Leek. The home is close to local amenities. The home was well-maintained and decorated throughout. The service has a vehicle, which is shared with another home in Leek. Records showed that thorough pre-admission assessments were carried out. Multi-disciplinary work was also evident. Prospective service users and their supporters were offered the opportunity to visit the home on a number of occasions before deciding to move in. A person-centred planning model has been adopted, which ensures that the service user needs, views and aspirations are at the forefront of any decision making. Support care and health action plans were in place. There was evidence that service users’ identified needs were being met appropriately. Opportunities for social interaction in the home and in the community were evident. Records showed that service users enjoyed a range of recreational, educational and social activities. Audits of service users’ participation provided an account of the number of activities engaged in over a period of time. Service users were supported to make choices in relation to their everyday lives and weekly discussions regarding meal-time choices were held in the home. Quarterly service user meetings were also held to discuss other significant issues. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 6 Health and personal care needs were recorded and there was evidence of regular monitoring action taken to ensure that service users’ needs were met. Systems for the safe administration and storage of medication were satisfactory, and staff had received appropriate training. The staffing and management arrangements were adequate to meet the needs of service users. Contracted bank hours and ad hoc agency hours were being used to ensure staffing levels were maintained to cover a 24-hour staff vacancy and staff sickness. Effective policies and procedures, mandatory training and regular fire and health and safety checks assured the health and safety of service users. What has improved since the last inspection? 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. 63 Junction Road DS0000004964.V280265.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 63 Junction Road DS0000004964.V280265.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): 2 and 4 The standard of assessment was high, with evidence that prospective service users were invited to visit the home and stay overnight prior to deciding to move into the home. EVIDENCE: Samples of two pre-admission assessment documents were inspected. There was evidence of multi-agency involvement and of opportunities for service users and their supporters to visit the home prior to deciding to move in. Visits included at least one overnight stay. The manager confirmed to the Commission for Social Care Inspection that it is confirmed in writing to each prospective service user that the service can meet their individual needs. Each of the records seen showed that service users had a contract/licence agreement with the housing association, and terms and conditions of residency were included in the service user guide and statement of purpose. 63 Junction Road DS0000004964.V280265.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, 9, 10 There was a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users’ needs. The standard of risk assessment was high, with evidence that service users were supported to take reasonable risks. EVIDENCE: Person-centred planning records were kept in individual bedrooms and other records were stored in the service office. Each of the service users have allocated key and support workers. Care records inspected showed that the assessed needs of service users were known and understood and there was evidence of regular reviews of care and support plans. Person-centred plans had been developed and were also reviewed regularly. The key workers met with the deputy manager monthly on a one-to-one basis to discuss the progress of the plans. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 10 There was evidence of excellent work done to ensure a service user who had a visual impairment knew who his key worker was, understood his rights and knew who to go to if he had any concerns. The key worker had produced an audio tape with this detail on it. In another example there was an explicit communication plan which provided staff with the information they required to interpret the non-verbal methods of communication used by the individual. Risk assessments had been undertaken to address known areas of risk - as with care plans these were also subject to regular review. 63 Junction Road DS0000004964.V280265.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): 13, 16, 17 There was evidence that service users accessed community facilities promoting their presence and participation. Dietary needs of service users were well catered for, with a balanced and varied selection of food available that met service users’ tastes and choices. EVIDENCE: Staff and service users met weekly to plan and discuss menus for the following week and there were additional regular (approximately) quarterly meetings to discuss significant events in the home, plans for social activities, and relevant policies and procedures. Preferred recreational activities were listed for each service user in their personal records. During the week of the inspection there were no college sessions due to the half-term holidays and staff were providing alternative leisure opportunities. 3 service users had been involved in activities in the local community during this visit. One service user was engaged in activity, looking at magazines with a member of staff and playing cards, a second was looking at and sharing photographs with staff, and a third service user was 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 12 enjoying listening and playing with an electric keyboard. One service user, although not engaged in activity, appeared to enjoy being a passive observer from discussion with staff it was apparent that the service user resisted active engagement in activities, presenting a challenge to the staff team, but it was pleasing to observe that efforts were continually being made to include her in the activity in the home. Records of participation were reviewed regularly to assess the number of activities service users were engaged in. Records showed that service users had enjoyed holidays last year and two service users were being supported to plan a holiday in the spring. Menus for the evening meal were planned weekly and meal times were flexible dependent on the planned activities and routines of service users. On the day of the inspection it was apparent that a choice was available on request. Lunch and breakfast options were chosen at the time of the meal. There was a written record of meal provided, it was suggested that a pictorial menu should be displayed in the home as a visual reminder to service users of the choices available. Records of meals provided showed a balanced diet was offered and there was evidence that referrals to dietetic service were made as necessary. 63 Junction Road DS0000004964.V280265.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, 21 Personal support in this home was offered in such a way as to promote and protect service users’ privacy, dignity and independence. The health needs of service users are well met, with evidence of good multidisciplinary working taking place on a regular basis. The systems for the administration of medication are good, with clear and comprehensive arrangements being in place to ensure service users’ medication needs are met. EVIDENCE: From discussion with staff and service users and from observation during the inspection visit, it was apparent that the personal care needs of service users were known and staff demonstrated sensitivity in meeting these individual needs. Health and personal care needs were being appropriately met. Records showed that service users were supported to attend regular health checks and appointments. There had been multi-disciplinary co-operation to access much needed treatment for one service, and despite earlier difficulties it was hoped that the treatment would go ahead. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 14 Specific health issues were monitored regularly and referrals had been made to appropriate specialist health services. Staff had also received training in relation to specific health issues such as epilepsy. Medication records were satisfactorily maintained and stock control systems and storage facilities were adequate. Protocols for the administration of asrequired medication were in place. All staff responsible for the administration of medication had undertaken certificated training. None of the service users self-medicated. The manager discussed bereavement care, and outlined her intention to broach the subject of preferences, in the event of the death of a service user, in respect of funeral arrangements at future review meetings. 63 Junction Road DS0000004964.V280265.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 system with evidence that service users feel that their views are listened to and acted upon. EVIDENCE: In two of the five relative questionnaires, relatives stated that they had not been made aware of the complaints procedure. This was discussed with the manager who stated she was aware of the issue and would be providing copies of the complaints leaflet to all relatives. There was excellent work undertaken by the key workers of one service user to record his rights to complain and the procedure on an audio tape. 63 Junction Road DS0000004964.V280265.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, 25, 26, 27, 28, 30 The standard of the environment within this home is good, providing service users with an attractive, clean, homely and safe place to live. EVIDENCE: The general appearance of the home was a homely well-maintained environment. The home offers a very pleasant lounge, which had been decorated and refurnished since the last announced inspection and a kitchen/dining room, with additional seating area. A carpet had been ordered for the stairs and hallway; new curtains were on order for the top of the stairs and a new sofa was also ordered for the dining room to replace two chairs. A sample of bedrooms showed that service users were supported to personalise their rooms. All bedrooms were for single occupancy and the two ground floor bedrooms had en-suite facilities. Each bedroom had lockable storage space. In one bedroom, a double bed had been customised for the service user following risk assessment. The manager was asked to consider providing a comfortable chair in this room, if it was safe to do so. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 17 Since the last inspection a shower had been installed over the bath on the first floor. Unfortunately, although the shower had been fitted, the water supply had not been connected. This issue must be resolved for the benefit of service users. Improvements have also been made to the access of the en-suite in a ground floor bathroom following risk assessment. The laundry room was located on the ground floor and had secure storage facilities for cleaning materials and hazardous liquids. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 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): 31, 32, 33, 34, 35, 36 Staff morale appeared to be good, resulting in an enthusiastic workforce that worked positively with service users to improve their whole quality of life. Recruitment records and the standard of staff training were good, with evidence that over half the staff have an NVQ qualification. EVIDENCE: Staffing levels for the day of the inspection included: the manager from 7.30am-6pm, 1x support worker 7.30am-6pm, 1x 7.30am-3pm, 2x 2.30pm10pm and 1 waking night staff from 9.45pm-7.45am. Four members of staff had achieved NVQ level 3, two had achieved NVQ level 2 and the deputy manager was undertaking the Registered Care Managers award and will be put forward for the NVQ level 4 in care and management. The numbers of NVQ-level trained staff exceeds the minimum standards. Recruitment records showed that all information required by regulation was in place. The service had a 24-hour support worker vacancy. Two new staff had been recruited since the last inspection and a student nurse had started her 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 19 placement. She confirmed that her induction into the home had been satisfactory. One member of the staff team was off sick, and one member of staff had left the service. Staffing levels were being maintained by the use of agency staff: a total of 17 shifts had been provided from the agency in the 8 weeks prior to the inspection. In addition a bank staff was contracted to work for 35 hours per week. Staff meetings were held approximately every three months. The manager indicated that staff supervision and appraisal were up-to-date. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 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): 37, 39, 40, 41, 42 The management arrangements at the home were satisfactory, providing service users with stability. Health and safety of service users was assured by good record keeping, policies and procedures and staff training. Service users and families views on the service had been sought and a review had been undertaken based upon the feedback. An action plan was being developed to improve the service over the next 12 months. EVIDENCE: Since the last announced inspection the manager had achieved the Registered care managers award and NVQ 4 in management. The deputy manager was undertaking the training. Two service users had been taken to the accident and emergency since the last inspection. One service user had suffered an injury the evening before the inspection, although a visit to the Accident and Emergency department had 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 21 determined that there was no significant cause for concern. All information relating to incidents and accidents reportable under regulation had been forward to the Commission for Social Care Inspection. Information in the pre-inspection questionnaire indicated that all servicing of equipment was up-to-date and the policies and procedures required in regulation and from good practice were in place. Feedback from relatives and service users was positive. Financial records showed that monies were being managed appropriately in the house. There was some discussion regarding the management of service users’ disability living allowance (the mobility component). It was agreed that the inspector would write to the organisation regarding this matter. All service users had their own bank/building society accounts. A representative of the organisation carried out monthly visits to the home to assess the performance of the service. Copies of the report produced had been forwarded to the Commission for Social Care Inspection. Quality audits of all aspects of the service delivery had been undertaken, including seeking the views of relatives and significant others. The manager was in the process of producing an action plan for the next 12 months based upon the outcome of the audits. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 22 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 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 23 X ENVIRONMENT Standard No Score 24 3 25 4 26 3 27 2 28 3 29 3 30 4 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 3 LIFESTYLES Standard No Score 11 x 12 X 13 3 14 X 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 4 X 3 3 3 3 X 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 23 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. 1 Standard YA27 Regulation 23(2) Requirement The registered person must ensure that the water supply to the shower is connected. Timescale for action 22/02/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2 Refer to Standard YA22 YA17 Good Practice Recommendations The manager should ensure that service users relatives have access to a complaints procedure. Service should consider displaying a pictorial menu to provide service users with a visual reminder of the meal choices available. 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 63 Junction Road DS0000004964.V280265.R01.S.doc Version 5.1 Page 25 - 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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