Inspection on 06/09/05 for 7 Blunt Street

This inspection was carried out on 6th September 2005.

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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

7 Blunt Street 12/03/09

7 Blunt Street 07/11/07

7 Blunt Street 14/11/06

7 Blunt Street 25/01/06

7 Blunt Street 17/02/05

7 Blunt Street 22/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 7 Blunt Street Stanley Common Ilkeston Derbyshire DE7 6FZ Lead Inspector Tony Barker Unannounced 6 September 2005, 9.10am th 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. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 7 Blunt Street Address Stanley Common Ilkeston Derbyshire DE7 6FZ 0115 9323491 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) United Response Christine Coates Care Home 3 Category(ies) of LD - 3 registration, with number of places 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 17/2/05 Brief Description of the Service: 7 Blunt Street is a semi-detached house in a small village development. Service users are provided with adequate accommodation and single rooms. There is a reasonably-sized rear garden. The Home offers personal and social care to people with a severe learning disability with associated conditions that include autism, sensory disability, epilepsy and challenging behaviour. Activities are planned to meet individual needs. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 4.25 hours and was a routine unannounced inspection. The last inspection took place in February 2005 and was an unannounced inspection. This inspection was the inspector’s first visit to the Home. The Manager, one member of staff and one service user were spoken to, records were inspected and there was a tour of the premises. All three service users’ records were examined as part of the case tracking method. The focus of this inspection was on progress made on the requirements and recommendations made, and those standards not assessed, at the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Information, for current and prospective service users, about the Home’s services must be focussed on 7 Blunt Street. Care plans must be regularly reviewed and revised and all records signed and kept up to date. A number of floor coverings need attention. Staff recruitment practices must be brought in line with current Regulations. The frequency of fire precaution training must be improved as must staff supervision sessions. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 6 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. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 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 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 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 & 5 Appropriate information about the Home was not fully available in order for prospective service users and their families to make an informed choice about where to live. Current service users were also not benefiting from this information. EVIDENCE: The Home’s service users’ guide and statement of purpose were seen. Neither was fully individualised to the Home, ie. the name of the service had not been added to each page and the manager and staff had fictitious names. Reference was made, in the statement of purpose, to the NCSC. However, the service users’ guide did include contact details of the CSCI in relation to making complaints. Contracts between the three service users and United Response were in place and were well drawn up with photographs and widgets (symbols). However, there was no contract between United Response and the purchasing authority with regard to one service user. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 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 & 9 Service users’ needs were not always being reviewed adequately. Their safety was being generally well considered through written risk assessments. EVIDENCE: Three service users’ care plans were seen as part of the case tracking process. These gave a comprehensive view of service users’ needs and action plans but there were still similar issues to those identified in previous inspections. Risk assessments were now being reviewed but on one file care plans were only being reviewed annually. The most recent complete care plan on two files was dated 1998. There were no background histories on any file, including that for the service user admitted 18 months ago. The minutes of one care plan review meeting had not been signed. Risk assessment documentation was extensive and useful and was being regularly reviewed. However, there were no written risk assessments, on file, relating to the service users’ epilepsy – although the Manager said she recalled writing reviews of these in August 2005. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 10 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) 12,13,14,15 & 17 Service users were benefiting from being part of the local community and from retaining good links with their parents. They were engaged in valued activities and leisure pursuits and had a positive relationship with care staff. They were offered a healthy diet. EVIDENCE: Each service user was being provided with a five-day-a-week day service – two from the local authority and one from United Response. Although Standard 12 was not fully assessed on this occasion there had been evidence at previous inspections that service users were involved in valued day service activities. The service user provided with United Response day services was involved in a varied and structured programme much of which took place in the local community. A range of stimulating leisure activities had been developed and photographs of these and of holidays were displayed in the dining room. There was close involvement by service users’ parents and this was appreciated by them. Positive interactions between staff and service users was observed at this inspection and there was a good atmosphere in the Home. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 11 Food stocks were seen to be adequate and written menus indicated that service users were provided with a varied and nutritious diet. A meal was not observed being eaten as all three service users were out at lunch time. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 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 standard(s) 18 & 19 Service users were receiving personal support in the way they prefer and require. Their physical health needs were being met. EVIDENCE: Service users had been told of this short-notice inspection and one was excited to meet the Inspector. Discussion with the Manager indicated that service users’ preferences for certain activities are respected but also that more ageappropriate alternatives are considered too. Service users’ independence was being encouraged through the use of symbols on each door in the building denoting the function of each room. However, staff training records indicated that Makaton was not being considered an appropriate training topic even though one service user does use this sign language. One service user’s file showed that an occupational therapist assessment was made in 2004. Each service user had epilepsy and an intercom was placed in each bedroom to address this. The Manager said she was considering specialist epilepsy mattress monitors as she recognised the potential intrusiveness of the present arrangement. A referral has been made to an orthopaedic specialist with regard to one service user. Staff were now receiving annual training in the use of medicines from an accredited trainer. Other aspects of Standard 20 were not assessed. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 13 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 14 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 Procedures were in place to enable service users to make known their views. EVIDENCE: The displayed complaints procedure had been amended to show reference to the Commission for Social Care Inspection. A separate complaints procedure, using widgets (symbols) was available for service users although an accompanying sheet still made reference to the National Care Standards Commission. There were on-going concerns expressed by neighbours about the level of noise from at least one of the service users. This matter was being dealt with in a constructive way. One of the senior care staff was attending an Adult Protection training course, run by the local authority, on the day of this inspection. Other aspects of Standard 23 were not assessed at this inspection. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 15 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 & 26 Service users were living in a generally comfortable environment although some floor coverings continue to reduce standards. EVIDENCE: The premises provided a generally pleasant, homely environment for the service users. However, carpets in the lounge, hall, stairs and landing were worn and still had not been replaced. The Manager said that quotes had now been obtained for these. Floor coverings in the back bedroom and upstairs toilet had been professionally cleaned but were still stained and in need of replacement. Service users’ bedroom doors were all lockable although there was no lockable space in the rooms. One bedroom seen was particularly well personalised while one front bedroom had a carpet in very poor condition beneath the sink. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35 & 36 Service users were being supported by a staff team that was effective but not always well-supported and supervised. Their needs were being met by staff who were generally well-trained although not consistently on fire precaution matters. Service users were not being fully protected by the Home’s recruitment procedures. EVIDENCE: One third of the staff group had a National Vocational Qualification (NVQ) at level 2 or above and the NVQ certificate of one staff member was seen on file. The staffing rota was seen to be satisfactory except that only the first names of staff had been recorded. The Home had one 30 hour vacancy and had used agency staff for 38 shifts in a previous eight week period. The Manager said that these are usually staff known to the Home – to provide consistency of care for the service users. The Home provided one waking staff on duty each night. The file of one member of care staff was seen. The job application form was satisfactory except that there was no recorded evidence of the staff member’s mental/physical fitness. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 17 The file also contained a personal training record dated 24 May 2004 as well as a copy of the staff group’s training matrix from 2003. The personal training record showed that the last fire training undertaken by this member of staff occurred on 3 March 2003 with the next “due on 2 March 2006”. The Manager said that new staff undertake induction and foundation training, using the Learning Disability Award Framework, within six weeks of appointment. This is enhanced by a United Response workshop operating as a tutorial group, she added. No staff training and development programme had been developed, as recommended at the last two inspections. The Manager said that staff supervision sessions were used to identify staff training needs. The staff file seen showed irregular supervision dates with the last three being in July and May 2005 and May 2004. The Manager said that supervision of the care staff was undertaken by the senior support worker with additional responsibilities. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 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) 40,42 & 43 The health, safety and welfare of service users was being protected. EVIDENCE: A good range of policies and procedures were in place except for the following three areas… • continence promotion • health and safety • hygiene and food safety. Good food hygiene practices were noted. Cleaning materials were kept under the kitchen sink in a locked cupboard with Product Information Sheets. Evidence of business planning and acountability was still not being held within the Home, as at previous inspections. The Manager was not aware of any business plan being in place. A current Employers’ Liability Certificate was seen displayed in the office. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 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 2 x x x 2 Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 x 3 Standard No 31 32 33 34 35 36 Score x 3 2 2 2 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 7 Blunt Street Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score x x x 3 x 3 3 C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 20 Yes 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 1 Regulation 4(1) 5(1) 5(3) Timescale for action The Company must ensure that 1 January the Homes statement of purpose 2006 and service users guide are fully individualised to the Home. Contracts between purchasing 1 February authorities and the provider 2006 organisation must be in place on all individual care records.(Previous timescale was 30/9/04). Service users care plans must 1 January be reviewed at least every six 2006 months Service users care plans must 1 January be revised periodically to ensure 2006 that staff are working from a current and relevant care plan. All records maintained in respect 1 of each service user must be December signed and dated. 2005 Risk assessments, relating to the 1 service users’ epilepsy, must be December written and maintained on file. 2005 The Other People to Contact 1 sheet, accompanying the service December users version of the complaints 2005 procedure, must make reference to the Commission for Social Care Inspection. The carpets in the lounge, hall, 1 stairs and landing must be December Version 1.40 Page 21 Requirement 2. 5 3. 4. 6 6 15(2)(b) 15(2)(c) 5. 6. 7. 6 9 22 17 13(4)(c) 22(7) 8. 24 16(2)(c) 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc 9. 24 16(2)(c) 10. 11. 12. 26 33 34 16(2)(c) 17(2) Sch 4 19 Sch 2 13. 35 17(2) Sch 4 23(4)(d) 14. 35 15. 16. 36 18(2) 1 March 2006 1 December 2005 Records of staff employed at the 1 January home must be as defined by (the 2006 revised) Schedule 2.(Previous timescale was 31/3/04). All records required to be 1 January maintained in the Home must be 2006 kept up to date - including staff training undertaken. Staff must be provided with fire 1 January training at a frequency no less 2006 that twice a year, if they undertake night shifts. A record of this training must be kept in the Home. All staff must receive formal 1 supervision at least six times a December year. 2005 replaced.(Previous timescale was 30/6/04). Floor coverings in the back bedroom and upstairs toilet must be replaced.(Previous timescale was 31/3/04). The carpet in one front bedroom must be replaced. Staff members surnames must be recorded on the staffing rota. 2005 1 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 6 Good Practice Recommendations Individual care records should contain a background history of the service users’ lives from before they lived at the home.(This was a recommendation from 22 June 2004) Staff should be provided with training in the use of Makaton sign language. Service users should be provided with lockable space in their bedroom or the reason for not providing this facility C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 22 2. 3. 18 26 7 Blunt Street 4. 5. 6. 7. 32 35 43 40 should be recorded on their care plan. 50 of the care staff should achieve an NVQ in care at level 2, at least, by 31 December 2005. All staff should benefit from a training and development programme that is laid out in an individual plan. A copy of the financial plan for the home should be available for inspection.(This was a recommendation from 22 June 2004) Policies and procedures should be developed as detailed in the body of this report. 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT 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 7 Blunt Street C02 C52 S19941 7 Blunt Street V242807 060905 Stage 4.doc Version 1.40 Page 24 - 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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