Inspection on 20/07/05 for 63 Junction Road

This inspection was carried out on 20th July 2005.

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

The inspector 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

63 Junction Road 15/02/06

63 Junction Road 29/09/05

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 Wendy Jones Unannounced 20 July 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 63 Junction Road Address Leek Staffordshire ST13 5QN Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01538 382542 Choices Housing Association Ltd Mrs Tracey Flanagan Care Home 5 Category(ies) of 5 LD registration, with number 2 PD of places 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 5 LD - 2 may be PD Date of last inspection 17 January 2005 Brief Description of the Service: 63 Junction Road is a well maintained domestic-style detached residence, which fits unobtrusively in to the surrounding suburban setting on the outskirts of Leek. The home is registered to provide care for five people with medium dependency needs and have learning disabilities who require 24-hour care.Accommodation I 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 making organisation who provide care and other services throughout Staffordshire and Stoke -on-Trent. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection visit carried out on 20 July 2005; information for the inspection was provided from discussion with staff and management and a relative, conversation with service users and an interview of a student nurse; observation of interactions and the physical environment; from inspection of staff rota’s, care records and other documentation pertinent to the inspection. At the time of the visit there were 3 service users residing in the home and 1 service user vacancy. All service users were in the home at some point during the inspection. What the service does well: The service has a Statement of Purpose and Service User guide. The guide was in a user friendly format. Care records for service users were observed to be comprehensive, with thorough assessment details and action plans and risk assessment to address any identified need. There was evidence of reviews of care plans and person centred planning meetings. Health needs were appropriately addressed with evidence that the service had supported individuals to receive health care services and treatment. Holidays’, short breaks or day trips were planned for all service users. Menu’s are planned weekly with service users, records of meals provided are maintained and monthly audits carried out to assess compliance against national government targets for healthy eating. Staffing levels were good and reflective of the needs of service users; staff training was reported to be up to date. Fire safety and health and safety records were accurately and regularly maintained. The environment was maintained to a good standard throughout. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 6 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 E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2. The homes Statement of Purpose and Service User Guide are good providing service users and prospective service users with details of the services the home provides enabling an informed decision about admission to be made. EVIDENCE: Since the last inspection the service has a new manager and has recruited a full staff team, a review of the Statement of Purpose and Service User Guide is to be undertaken to ensure that it accurately reflect the current staff team. The service provides care and accommodation for up to five service users who have a learning disability under the age of 65 years, two of whom may have an additional physical or mobility disability. The current three service users were suitably placed given the stated admission criteria. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,9. 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, and to offer service user support to make decisions regarding their care. EVIDENCE: The service operates a person centred planning model, which places the service user at the centre of the care planning, decision making. A formal planning meeting is held annually, participants are agreed with the service user; a regular monthly review of agreed action/care plans is undertaken and a second formal review after 6 months. In addition the key worker meets with the deputy manager every 6 weeks to discuss progress. The model follows the principles of care associated with services for people with learning disabilities, and recommended in the government white paper Valuing People. Goals are agreed under each of the headings, i.e. community presence, participation, inclusion, choice, rights, respect and so on. Under each of these headings the service user is supported to set goals for the following twelve months. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 10 Case tracking a service users care from the PCP meeting evidenced that the service user needs had been appropriately assessed and care plans were in place to meet the needs. Referrals to specialist services had been made where appropriate. Individual risk assessments had been completed and were subject to monthly review. Evidence from the day to day records and from the observations made during this visit, indicated that service users were supported and encouraged to make decisions regarding their day to day lives. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13,14,15,17 Service users opportunities to access recreational and occupational activities outside of the home were limited. Service users were supported to maintain contact with relatives, friends and supporters. 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: During case tracking, it was evident from the sample of weekly timetables seen, that some service users participation in external, meaningful activities was limited, for a number of reasons; due to the summer college closure, specific care needs or due to limited availability of appropriate activities. Each service user had a participation options list, which provided staff with information about a range of activities that service users were known to enjoy. From one sample there appeared to be some confusion regarding how the 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 12 activities were recorded for audit and statistical purposes, for example, one service users leisure and recreational records indicated that they had enjoyed 4 leisure and recreational activities on one day, when this was cross referenced with the care records and other supporting documentation it was not possible to establish what activity had occurred to merit this score. From discussion with the manager it was suggested that staff should receive more guidance In understanding how the system for scoring the participation of service users in activities is scored. The service makes arrangements for service users to plan menu’s on a weekly basis. Guidance is given to supporting the service user to make healthy choices where possible. The records of meals provided indicated that this approach was reasonably successful. Special dietary needs of service users were recorded. Alternatives to the main meal choice were also recorded. Monthly monitoring of food provided gave the manager information relating to how the service was meeting the national government guidelines in relation to healthy eating. An annual dietetic assessment was carried out by the Health Authority dietician. Service users were also supported to have free access to food and drink and were encouraged to participate in food preparation and shopping as often as they wished. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20. The personal and health care needs of service user were known to staff, recorded and had been acted upon to ensure that they were met. The systems for the safe administration of medication were satisfactory with evidence of good record keeping and appropriate storage of medication to ensure the well being of service users. EVIDENCE: The personal and health care needs were appropriately met. Staff were observed to attend to the personal care needs of service user in a sensitive manner. The records including health assessments and health action plans, showed that the health needs of service users had been monitored closely and acted upon promptly. There was evidence in the records that service users were supported to attend health related appointments including preventative health care checks, medication reviews and routine well man/woman checks. Specialist health professionals were also accessed as the need arose. It was recognised at this inspection that there had been an increase in the physical health care needs of some service users, and through case tracking evidenced that the service had acted to address any areas of specific need. Any delay’s 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 14 in treatment that were discussed during this visit were outside of the control of the service, but they had also sought support from Patient Liaison and PCT personnel to support service users access to appropriate treatment. A relative gave positive feedback about the support she and her family had received and how they were kept informed and involved in the on going care needs of her relative, describing a shared care approach. The systems for the safe administration of medication were good; records showed that medication was signed for on each occasion it was delivered. A record of staff signatures was included in the medication file. It was not established during this visit if all staff responsible for the administration of medication had attended a certificated training course. The storage of medication was adequate, none of the service users self medicated. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 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 standard(s) 22,23 The home has a satisfactory complaints system with evidence that service users and their supporters feel that their views are listened to and acted upon. The procedures for the protection of Vulnerable Adults were satisfactory, staff received training and are regularly updated in recognising and reporting abuse. EVIDENCE: The service has a complaints and Protection of Vulnerable adults procedure for staff to follow. The complaints procedure had been produced in a user friendly format which included picture referencing and photographs of key staff. All staff received Vulnerable Adults training at induction and the procedures were revisited at staff meetings. The Commission for Social Care Inspection has received no complaints in respect of this service. One relative and a student nurse gave very positive feedback about the service and how it responded to the needs of service users. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 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 standard(s) 24,27,28,30. The standard of the physical environment was high throughout creating a comfortable and safe environment for those living there and visiting. EVIDENCE: This visit did not include inspection of the bedrooms, but should be noted that all bedrooms were for single occupancy, three were located on the first floor, and two on the ground floor the ground floor bedrooms had en-suite facilities and had been adopted for service user who had some mobility difficulties. The standard of physical environment was good throughout, providing service users with a homely and clean living space. Shared space was provided in a main lounge and in the kitchen dining room. Bathing and toilet facilities were available in adequate numbers to meet the needs of service users, the main bathroom was located on the first floor, and an additional toilet was located on the ground floor. The laundry room was compact, but provided adequate laundering facilities. To the front of the property there was a drive and small walled garden area and a driveway with parking for one vehicle. To the rear the service users had access to a sheltered garden and patio area. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,35 Staff morale was high resulting in an enthusiastic workforce that worked positively with service users to improve their whole quality of life. EVIDENCE: Staffing levels for the day of the inspection included the manager 8am-6pm, the deputy manager from 7.30am-3pm and a student nurse whose hours were additional to the allocated hours for the day. 1 support worker from 2pm10pm and 1 waking night staff. The total weekly hours were recorded as 375 per week. A student nurse was interviewed during the inspection and gave very positive feedback regarding the management of the home, the effectiveness of the staff team and the support she has received. Each service user was allocated a key worker and the records showed that the care needs of service user were known and understood by the staff team. The manager indicated that mandatory training was up to date or scheduled, and two new staff were undertaking their induction programme. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,42. The manager is supported well by her senior staff in providing clear leadership throughout the home with all staff demonstrating an awareness of their roles and responsibilities. EVIDENCE: Since the last inspection the care manager of the home has changed, the new manager has yet to be approved by the Commission For Social Care Inspection, but has submitted an application. During interview a student nurse at the end of her placement gave very positive feedback about the service, and the management of the service. She reported that she had been fully supported throughout the placement felt that the service was well managed. Health and safety audits were recorded daily and weekly, risk assessments were in place. Fire safety checks had been undertaken and recorded appropriately, with weekly fire alarm, emergency lighting checks. Fire drills were recorded at regular intervals the records showed that all staff had been involved in at least 1 fire drill this inspection year. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 x 3 Standard No 11 12 13 14 15 16 17 x x 3 2 3 x 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 63 Junction Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 3 x E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 20 no 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 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 YA 14 YA14 Good Practice Recommendations The service should give consideration to improving the opportunities for service users to participate or engage in recreation and occupational activities otside of the home. The service should ensure that all staff undertand the criteria for scoring service users participation in leisure and recreation activities. 63 Junction Road E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Stafford - 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 E51-E09 S4964 63 Junction Road V240572 200705 Stage 4.doc Version 1.40 Page 22 - 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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