Inspection on 16/08/05 for 64 Stagsden Road

This inspection was carried out on 16th August 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 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

64 Stagsden Road 09/03/09

64 Stagsden Road 06/03/07

64 Stagsden Road 17/01/06

64 Stagsden Road 11/03/05

64 Stagsden Road 13/07/04

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Pemdale

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

CARE HOME ADULTS 18-65 64 Stagsden Road Bromham Beds MK43 8PU Lead Inspector Ansuya Chudasama Announced 16 August 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. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 64 Stagsden Road Address Bromham Beds MK43 8PU 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) 01234 826106 Walsingham Steven Iodice care home 5 (5) Category(ies) of LD - Learning Disability registration, with number of places 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11.03.05 Brief Description of the Service: 64 Stagsden Road is a detached residential house for five service users with learning disabilities. The home is managed by Walsingham organisation. The accommodation consists of four single bedrooms, a lounge, dining room, staff office, kitchen, and laundry. The bathroom was on the first floor and there was a toilet on the ground floor. Linked to this was a two bedroom semiindependent unit in what had been the garage. This unit had a lounge/diner kitchen and bathing facilities with a shower. One service user occupied the unit and the other bedroom was used for staff sleeping in.room. There was a goodsized enclosed garden to the rear of the property, which had a greenhouse, vegetable patch, lawn and flowerbeds. The house was located in the riverside village of Bromham. The village had a post office, take away shops, a small supermarket, two churches, a library and several pubs. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken at 09.30, and it took place over 5 hours. The registered manager, Steven Idice was present at the inspection. The inspection was comprised of a tour of the communal areas, some of the service users’ bedrooms, talking to staff and link workers of service users, and talking to service users. Two service users’ case records and other documents were inspected in detail. What the service does well: The manager was experienced and ran the home well. The staff found the manager very supportive and helpful. The staff spoken to enjoyed working at the home and with the service user group. It was also stated “that the whole focus of the home is geared towards service users”. The staff provided service users with advice and information and used pictures, verbal communication, and sign language in their meetings to get them involved in the running of the home. They were also observed treating them as individuals, and with respect. Service users stated that they enjoyed the meals that were provided by the home. They found the staff very helpful and one stated that “we all have different interests and activities and the staff help us to go to them or take part in them”. Service users were offered a variety of activities and they choose the activities and holidays. Service users personal and health care needs were being met by the home. The home had good quality monitoring systems to assess the quality of the services provided. A letter received from a member of the stakeholders meeting stated that they found the “home clean, tidy, with a peaceful atmosphere”. The manager and staff were welcoming “and eager to explain the every day running” of the home and the service users appeared to be well cared by staff. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 1,2,3,4,5. The homes had a statement of purpose and an excellent service user’ guide which, provided prospective service users and their families information of the services the home provides to enable an informed decision about admission to the home. EVIDENCE: The home had a statement of purpose and a colourful service users’ guide, which was completed by staff, service users and the manager. The home had not admitted any new service users since four years ago. The last service user admitted to the home had trial visits to the home with his family before making a decision to move into the home. The home did not admit any emergency admissions or service users who’s needs they could not meet. All service users had new pictorial contracts, which were very good. The contracts seen were signed by the manager, service user, and their family member or an advocate. The information in the contract was explained to service users by staff. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 6,7,8,9, There was clear and consistent care planning systems in place to provide the staff with the information they needed to meet the needs of the service users to a high standard. EVIDENCE: Two service users’ care plans case tracked contained information on how service users goals and aspirations were to be met by the home. Some of the information needed expanding. The service users were involved in drawing up their care plans and they also signed them to agree to working towards their goals. The staff spoken to stated that they had been involved in the care plans and they also understood them. It was also stated that the plans were being reviewed on a regular basis. Risk assessments on service users were carried out in detail. Service users’ comment cards received were very positive. Comments such as “we have a house meeting every month where we talk about different things” and “The staff ask us for our ideas and we can choose things and tell staff what we think” showed that the service users were involved in the decision making in the home. This was further confirmed by talking to service users. The home had an advocate who visited a service user on a weekly basis and positive comments were received about the home. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 10 Records showed that staff supported service users to manage their finances. The money checked and records inspected showed this was managed well. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 11,12,13,14,15,16,17. EVIDENCE: The staff empowered service users to make decisions about their lives by providing them with advice, information and assistance. Service users choose the meals for the week by using pictures. It was stated by service users spoken to that the meals provided were excellent. Service users had a day back at the home to work on their independent living skills. A rota for domestic chores was seen and service users decided for themselves by choosing the chores that they wanted to undertake. They did this by putting their photograph on the task that they wanted to undertake. Service users were also involved in recruiting permanent and agency staff. Service users attended staff meetings on a rotational basis when nonconfidential information was being discussed. One service user also attended the stakeholders meetings held on a three monthly basis. The service user also completed a report about the home with the support from staff and by using pictures to the meeting. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 12 Most of the service users attended day care and enjoyed this. One service user who did not attend day care had a weekly programme. This showed that he undertook many activities both in doors and outdoors. All service users attended a variety of activities and holidays that were chosen by them. The home had good relationships with service users’ families and friends. They visited the home and attended review meetings and social events. The care plans had information on how service users maintained contact with families and friends. All service users opened their own mail and staff helped them to read the content. Service users capable of having a key to their rooms were offered one and this was risk assessed. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 18,19,20,21 The knowledge of staff, safe systems for administering medication and detailed care planning meant that the health needs of service users are met. EVIDENCE: The care planning document had information on how service users personal care needs were being met by the staff. Routines for mornings and evenings was recorded in detail so staff were aware how to meet each service users needs. The service users were also able tell staff how they wanted to be helped. One service user stated that the staff helped with his personal care needs and they were very helpful and respectful. Bath aids were provided to maintain the service users’ independence. Nurse call systems were also available in the toilets and bathrooms. All the service users were appropriately dressed and those spoken to stated that they choose and purchased their own clothing and staff supported when required. Service users’ spoken to and their files seen showed that their health care needs were being met by the home well. Appointments to the health professionals were recorded well. The staff spoken to were able to give detailed information on how they met service users personal and health care needs. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 14 Information on medication was recorded in the care plan. All staff who gave out medication had received the accredited training. Information on burial arrangements was recorded and discussed with some service users. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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 staff have good knowledge and understanding of adult protection issues, which protect service users from abuse EVIDENCE: The home had a pictorial complaints procedure. Service users comment cards received stated that they knew who to talk to if they were unhappy. The procedures were explained to service users by staff. The home had not received any complaints since the last inspection. It was stated that if any service users had any concerns they would tell the staff or the manager. The staff were also able to tell if a service user was unhappy by their body language and through their behaviours. It was stated that one service user who did not communicate verbally, was able to use simple sign language and different behaviours to tell staff when they were unhappy. The staff and service users understood basic makaton sign language. An advocate also monitored service users concerns and prepared a report on their findings to the stakeholders meetings. The staff spoken to had an understanding about adult protection issues and knew what to do if they suspected any kind of abuse. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 24,25,26,27,28,29,30 The premises were well maintained so as to allow all those living at the home to enjoy a homely and comfortable environment that was safe, clean, and hygienic. EVIDENCE: The premises were clean and homely. The service users’ bedrooms seen were individualised to meet their needs. One of the service users’ bedroom was being sorted to ensure she had matching furniture. The service users sink needed replacing as it was cracked. A proper shower was also required in the upstairs bathroom. The home had an attractive lounge and it had recently been refurbished and looked very attractive. New settees, a TV, a clock, and curtains had been purchased. The down stairs toilet had been redecorated. The dinning room in the main part of the building needed to be more homely and brighter. The annex was well maintained and had a lounge/diner/kitchen. One service user lived in this accommodation. The ground floor shower had been adapted to meet the needs of the service user living in the annex. The person also had a low bed, flashing light, and a vibrating buzzer to enable him to react to the fire alarm. The service users helped choose the décor for the communal areas. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 31,32,33,34,35,36 The home provided very good training so that the people living at the home had their needs met by competent and suitable staff. EVIDENCE: The staff spoken to had received job descriptions and they understood the aims and objectives of the home. They had also completed the induction training when they first started employment. Some of the staff were undertaking NVQ level 2 or3 in care. However had NVQ level 2or 3. Training undertaken by staff was discussed and it was stated that all staff had received the statutory training as stated in the standard. The staff stated that they now received supervision on a monthly basis and this was good. It was also stated that staff meetings were held and they were good. All staff enjoyed working at the home and with the service user group. They also worked well as a team. The staff were observed speaking to service users in a positive and encouraging manner. The inspector was informed that the home had been very short staffed recently, however they had recently recruited a new member of staff. The vacancy hours were worked by the same agency staff on a regulars basis to provide continuity to service users. It was stated that the agency staff were very good. The staff files were not available for inspection. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 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) 37,38,39,40,42, The home has an experienced and committed manager who ensures strong leadership, and safe working practices so that service users health, welfare and safety are safeguarded. EVIDENCE: The manager has 13 years experience of working with service users with learning disabilities. He was doing the NVQ level 4 in management and care. The staff and service users found the manager very supportive. The home undertook fire testing on a weekly basis, emergency lighting on a monthly basis, and fire drills on a regular basis. The staff and service users spoken to knew what to do, when they had fire drills. Health and safety issues were discussed with staff and service users. The home had a flood because one of the service users left the tap on in the bathroom. The ceiling in the kitchen was slightly damaged and the manager stated that this was being dealt by the organisation. An advocate and a service user undertook a visual maintenance inspection in the home on a quarterly basis. A written report was produced on the findings and discussed at the stake holders meetings. The home 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 19 undertook service users surveys, service audits, regulation 26 visits, three monthly stakeholders meetings and annual reviews to monitor the quality of care and aims and objectives of the home. 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 20 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 4 3 3 3 4 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 64 Stagsden Road Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 x 3 x I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 21 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 YA34 Regulation 17 Requirement The registered person must ensure that staff files are available on the premises as stated in Schedule 4 of the Care Homes Regulations 2001. Timescale for action New.date 30/10/200 4 New date 31/6/2005. New date 20th December 2005 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 Good Practice Recommendations 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF 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 64 Stagsden Road I51 S14973 64 Stagsden Rd V232219 160805 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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