Inspection on 07/02/06 for 65 Churchill Road

This inspection was carried out on 7th 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 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 02/03/07

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 Unannounced Inspection 7th February 2006 02:00 65 Churchill Road DS0000016351.V282118.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 65 Churchill Road DS0000016351.V282118.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. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 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.V282118.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21st July 2005 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.V282118.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was undertaken on one afternoon and followed up by a visit the following morning. Both of the service users were seen and spoken to. Two members of staff were also seen during the visits. The inspection consisted of talking to the service users and staff, looking at the communal areas, and inspecting some of the records relating to healthcare, medicines and planes’ of care. The home accommodates service users who are seen as vulnerable and it was evident that staff were providing the support and guidance needed. It was felt that there was a pleasant and relaxed atmosphere in the home and that the home was meeting the needs and wishes of the service users. What the service does well: What has improved since the last inspection? 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 6 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.V282118.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 65 Churchill Road DS0000016351.V282118.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): EVIDENCE: Not inspected 65 Churchill Road DS0000016351.V282118.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, 7, 9 The needs of the service users are clearly identified, and reviewed on a regular basis and wherever possible met. EVIDENCE: Each service user has “guidelines for working” and the member of staff on duty was clear about the contents. This includes any particular concerns and offers staff a clear understanding of how they are managed. There is also an Individual Personal Programme that is reviewed every three months, however the examples seen indicated that the last review was December 2005, and the date of the next review June 2006. The programme when reviewed indicates actions on specific issues e.g. management of behaviours. The plan seen clearly stated the objective and the overall aim. The inspector was advised that most plans are short term and often require amendments before objectives are achieved. The inspector discussed the current method of care planning which is used and what options were available. It is recommended that the question of care 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 10 planning is discussed between the Trust, the Registered Manager and senior care staff. There is also an annual review, which is undertaken by the funding authorities. It was evident that needs and wishes are identified and where ever possible met. 65 Churchill Road DS0000016351.V282118.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): 12, 13, 15, 16 Service users have adequate and appropriate stimulation. This is provided by activities, access to the local community and the ability to maintain outside relationships. EVIDENCE: Service users have a weekly “activity” programme and this includes attending college and Spring Mill events. It was noted that one service user is able to enjoy one to one activities and this includes activities of the service user’s choice. It was felt that the activities were the service users choice and were appropriate. They are involved in the local community to include a local church. One service user is able to access facilities without staff supervision. Annual holidays are arranged each year and service users are consulted about where they would like to go. Support is given to promote and support links with families and friends. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 12 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 Health care needs are identified and met in a way service users prefer. EVIDENCE: The support provided by the staff is appropriate to the needs of each individual, and the support and guidance given during the inspection confirmed this. The home keeps records of all treatments received/required and this is updated in a monthly report. There was no self-medication with a minor exception that a small amount of non-prescribed medicines are held by one service user. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 13 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 The views of service users are always taken into consideration when practices in the home are determined. Competent and sensitive staff ensure service users are protected from abuse. EVIDENCE: During the inspection the inspector saw both service users and this included times when they were engaged with staff. Staff on duty were seen as excellent listeners who gave their time to any request, and were competent and sensitive to each request. The exchange between service users and staff is a daily occurrence and their views and wishes are expressed and subject to risk assessment are met. A member of the Trust also visits the home monthly under Regulation 26 The staff have recently received further training in the identification of abuse and this was provided by the employing Trust. There is a record of the administration of medicines. One service user keeps a small amount of homely remedies in his bedroom, which is locked when unattended. It is recommended that a locked facility is provided for the medicines to be held in his bedroom. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 14 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 The home has been maintained to a good standard and provides a comfortable physical environment. However this appears to be at times compromised by the lack of toilet facilities. EVIDENCE: The communal areas, and the bathroom/toilet were seen. The service users bedrooms were not inspected on this occasion. The home has been maintained to a good standard, the furniture was appropriate and in good condition. There is one bathroom, which included a toilet. During the inspection one service user who a wanted to both had to wait some time before the bathroom was free. He also advised the inspector that there had been times when his biological needs were so great, and the facilities so limited, that he was obliged to make his way to the garden to relieve himself. The question of adequate toilet/bath facilities must be reviewed with the objective of ensuring needs are met. There is a shower adjacent to the bathroom, but to use this the door has to be left open, as there is no light. The options would seem to be, fit lighting and 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 15 use the shower, disable the facility in its present form or finally consider what other uses it may have. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 16 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, 35 Service users have not always been adequately supervised and it is anticipated that the proposed review of staffing will ensure adequate supervision id provided. EVIDENCE: The home has a registered manager but the home is run on a day to day basis by a “senior carer”. There is a staff rota and this is completed at the headquarters of the Trust with the guidance of the registered manager. The home is not staffed at all times during the waking day. A judgement is made between the senior carer and the registered manager about the times staff are required to be on duty in the home. However, the inspector was advised that it was now felt that due to recent events staff should be on duty when service users are at home and that the new rota would reflect the changes. It is for the home to determine minimum staffing levels and when they should be deployed in the home. However, it would be helpful if the Trust through the registered manger identified the criteria used and those involved in the decision making. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 17 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): 42 Risk assessments were not clear about the amount of time a service user could be alone and unsupervised in the home. EVIDENCE: The inspector discussed the specified practice of service users being unsupervised in the home. The senior carer told the inspector that risk assessments are written but there are no specific maximum times for them to be unsupervised. If service users are to be left unsupervised it is essential that the arrangements are clear and available for all staff. Included in the risk assessment was the ability of the service user to respond to emergencies, and the inspector was assured that both service users were seen as competent to act, e.g. in the event of a fire. It is recommended that fire instructions are repeated at regular intervals and that the instructions are recorded on the respective risk assessments 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 18 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 2 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 3 X X X X X X 2 X 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 19 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 YA42 Regulation 23 18 13 Requirement Review existing toilet/bathing arrangements. Review daytime staffing arrangements. Ensure individual risk assessments are precise e.g. service users who are left unsupervised in the home. Timescale for action 30/05/06 30/04/06 30/04/06 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 YA6 YA23 Good Practice Recommendations Review care plan format. Provide a lockable facility for homely medicines. 65 Churchill Road DS0000016351.V282118.R01.S.doc Version 5.1 Page 20 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.V282118.R01.S.doc Version 5.1 Page 21 - 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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