Inspection on 02/03/07 for 65 Churchill Road

This inspection was carried out on 2nd March 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

65 Churchill Road 14/01/08

65 Churchill Road 07/02/06

65 Churchill Road 21/07/05

65 Churchill Road 03/03/05

65 Churchill Road 13/04/04

65 Churchill Road 14/11/03

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 65 Churchill Road 65 Churchill Road Forest Green Nailsworth Glos GL6 0DE Lead Inspector Mr Tim Cotterell Key Unannounced Inspection 2nd March 2007 10:00 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 65 Churchill Road Address 65 Churchill Road Forest Green Nailsworth Glos GL6 0DE 01453 833299 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) Gloucestershire Group Homes Joanne Wheeler Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th February 2006 Brief Description of the Service: 65 Churchill Road is a detached house that is registered to accommodate three service users with Aspergers Syndrome. Currently the home only has two service users living there. The organisation offers a very specialised, individual service for people with Aspergers Syndrome, and staff receive training to support service users appropriately. The home is conveniently situated in Nailsworth, which enables service users to access local community facilities. Service users also have access to transport that is provided by the home and this enables them to access facilities in several other local towns. The home is not staffed at all times, but a member of staff is always on call if they are needed. Family and friends are welcome to visit the home at any time and service users can meet them in private if they wish to. The service users attend various activities, which include Day services provided by Gloucester Group Homes, and they are given the opportunity to attend College courses if they wish. The Inspector has visited the day service that is provided by the organisation, it has been developed specifically for people who have Aspergers and offers service users very individual programmes to meet their needs. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. Three of the support workers were seen and spoken to and this included the senior support worker. One of the two service users was seen and spoken to. The inspector will meet the registered manager within the next few weeks. In response to the Commissions questionnaire the issue of staffing was raised by staff and this related to the arrangements to provide a full time and permanent service during the waking day. It was evident that staff where clear about their roles and responsibilities and that the service user was well cared for and happy and comfortable in the home. The management of medicines and monies was inspected and the accommodation seen. Care planning was discussed and the inspector was advised that the process was being reviewed and that changes were being considered. It was evident that the home, which accommodates very dependant adults was operating in a relaxed manner and staff had a good relationship with the service users. What the service does well: There is an excellent relationship between staff and service users. The day to day practices are determined by the individual needs and wishes of the service users and the flexibility of the service ensures they are met. Service users have an active and varied lifestyle and are supported and guided by staff where this is appropriate. They are also able to spend time on their own with unobtrusive supervision. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 6 Often the practices of a home ensure the needs of the staff are seen as paramount, at this home it is the needs of the service users, which are paramount. 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. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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): Standards not inspected. EVIDENCE: The standards were not inspected, as the home had not admitted any new service users since the last inspection. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 7 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service Users needs and wishes are identified and addressed. They are able to make decisions about what they do and responsible risk taking is encouraged EVIDENCE: Service users have an annual review and they are encouraged to contribute. The Individual Personal Programme provides clear objectives and is reviewed every three months. One programme was seen and this included the aim, the objective and staff action plan. The plan had been reviewed in January 2007.There is also a personal profile, which is a working document and provides staff with clear guidance about how some behaviours should be managed. Whilst there were not any specific behavioural programmes staff were aware of the skills available in the Community Learning Disability Team. The inspector was told that care planning with specific reference to service users disabilities is being reviewed. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 10 Service users are given support and guidance and this enables them to make decisions about how they spend their days. Responsible risk taking is encouraged and written asseeemnst are completed and reviewed. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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): 12 13 15 16 17 Quality in this outcome area is good. Service users enjoy appropriate activities and are involved in the community. There is adequate support for family/social relationships. Everyone in the home is involved in the menu planning This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users have a weekly routine and this included activities with staff in the home, day centre staff and some supervised events. The activities consisted of things service user were interested in and where support was needed this was readily available. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 12 The local community forms a part of their lives and this can be accessed with or without supervision. The village and shops are within walking distance of the home. Families and friends form an important part for the service users and support from staff was evident. Service users are afforded the rights that other adults enjoy and there would only be a restriction in their rights if the decision was agreed and recorded in the care plan. The menus are agreed and written after consultation with service users and the four week menu consisted of “healthy “ meals within balanced diet and wherever possible meals of their choosing. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 Quality in this outcome area is good. Support is offered in an individual manner and there is good management of all physical needs. The administration of medicines must be regulated in a more robust manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are provided with personal support, which gives them a service, which is dignified and offers privacy. Health care needs are seen as important and every effort is made by staff to encourage service users to use the services in the community. There are records of all advice and treatment given. If more specialist care is needed staff would contact the Community Learning Disability Team. The records indicated that all of the resources in the community were being used. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 14 The management of medicines was discussed and the records inspected. In the current month there was an omission. This was brought to the attention of the senior support worker and the support worker who had been on duty and responsible for the administration and recording of medicines that day. The view of the staff was that this was an oversight and that the medicine had been given. The importance of records was stressed with staff and it is essential that the records are checked. It is recommended that this aspect of care is included in the Regulation 26 visits of the Registered Manager 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 23 Quality in this outcome area is good. Service users live in a safe environment where their safety and rights are assured. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has a written complaints procedure. Whilst service users may not completely understand the written procedure the inspector felt that the open environment in the home, together with the access they have to others provided them an adequate degree of security Staff were very aware of the issues of potential abuse and were seen to be providing a service which protected service users from abuse. There was a good relationship between service users and staff. The evidence from the exchanges seen during the inspection confirmed to the Inspector that service users would feel comfortable about bringing matters to the attention of the staff in an informal manner. If there were serious concerns service users would have a direct line to the management of the home through their attendance at the day centre. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 30 Quality in this outcome area is good. The home has been maintained to a good standard and provides a comfortable environment. It is doubtful if the existing toilet facilities meets the needs of service users and staff at all times. This judgment has been made using available evidence including a visit to the service. EVIDENCE: The home continues to be maintained to a good standard and provides a pleasant and comfortable environment. All of the accommodation was seen. There has not been any response to the issue of the adequacy of the toilet facilities or indeed any evidence of review or action. The facilities consist of a 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 17 bath/toilet and a separate shower area where the inspector was told the door needs to be open during showering, as there is no light. There continues to be times when the bathroom is in use and the other service user needs access, in the circumstances the home is again asked to review the position and consider how facilities can be amended/improved. The use of the shower as it is, is clearly inappropriate and the shower should be available with adequate lighting to ensure privacy and dignity. The senior support worker who was present for some part of the inspection stated that routines, which were established, meant that the bath/toilet was available for the individual without them having to wait. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 35 Quality in this outcome area is adequate. The Trust must review the staffing compliment and arrangements to ensure there is consistency of care Staff had a positive relationship with service users and were seen as competent and sensitive to their needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: At the last inspection the home was described as semi independant and was not staffed at all times. The inspector was advised that the home is now seen as a “24 hr unit” where staff are required at all times. To accommodate for the extra staffing needs the home relies upon bank staff which are about ten in number. At the time of the visit eight bank staff had been providing cover in the home. In view of the dependency of the service users, and the clear benefits of having identified members of staff who are employed on a long term basis it would be helpful to know what plans the Trust has about staffing in the future. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 19 Bank/relief staff are seen as something of a short term measure to meet emergencies and not as a permanent measure. It is appreciated that bank/relief staff are usually ex members of staff who are known. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 42 Quality in this outcome area is good. The health and welfare of service users is seen as paramount and wherever possible their views are sought and considered. The home is well run and is managed in an open and democratic manner. EVIDENCE: The registered manager of the home is also responsible for other care homes and the day to day responsibility rests with the senior support worker. The staff in the home advised the inspector that they meet as a group on a regular basis; the meetings were led by the senior support worker. It would seem apprpriate that the Registered manager attended a number of the 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 21 meetings to ensure there is good communication and understanding between the Trust and the home. 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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 X 3 X 4 X 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 X 3 X 3 X X 3 X 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 23 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. 2. 3. Standard YA24 YA32 YA20 Regulation 23 18 13 Requirement Review existing toilet/bathing arrangements. Review daytime staffing arrangements. Ensure there are written records in respect of the administration of medicines Timescale for action 30/05/07 30/05/07 30/04/07 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 65 Churchill Road DS0000016351.V331199.R01.S.doc Version 5.2 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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