CARE HOME ADULTS 18-65
7 Debdale Road 7 Debdale Road Wellingborough Northants NN8 5AA Lead Inspector
Rajshree Mistry Unannounced Inspection 25th January 2006 03:40p 7 Debdale Road DS0000012762.V280139.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 7 Debdale Road DS0000012762.V280139.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. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 7 Debdale Road Address 7 Debdale Road Wellingborough Northants NN8 5AA 01933 276930 01933 229606 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) www.caremanagementgroup.com Care Management Group Limited Mrs Hilary Jennifer Watt Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. By Agreement there is 1 Service user who has a mental disorder. No further service users are to be admitted in this category. By agreement there is 1 service user who has learning disabilities over 65 years. No further service users are to be admitted in this category. 20th April 2005 Date of last inspection Brief Description of the Service: 7 Debdale Road provides care for five adults with a learning disability. The home is situated close to Wellingborough town centre and is in close proximity to all local amenities with good transport links both by bus and train into central Northampton. The home is a semi-detached house in a residential street with a pleasant rear garden. Three residents are accommodated in single rooms and two residents share a bedroom. Communal areas consist of a lounge and a kitchen/diner. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection of the service, which took place on the late afternoon of 25th January 2006 and lasted 2½ hours. This is the second regulatory inspection of the service addressing the remaining core standards. The focus of the inspection undertaken by the Commission for Social Care Inspection (CSCI) is upon the outcomes for the resident and their views of the service provided. The primary method of inspection used was ‘case tracking’ two residents. The inspection consisted of a group discussion with the residents and members of staff, a tour of the home, review of the residents’ records and observation of care practices. The inspection also reviewed of the requirements and recommendations from the last inspection. What the service does well: What has improved since the last inspection?
Since the last inspection the following improvements have taken place: • New double-glazed windows throughout the home. • Residents’ bedrooms have been painted and new carpets have been fitted. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 6 • Residents went on a two-week holiday to the Greek Islands, short breaks to London and individual residents have been away visiting their families and friends. 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. 7 Debdale Road DS0000012762.V280139.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 7 Debdale Road DS0000012762.V280139.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: The core standards were inspected at the last inspection and were met. 7 Debdale Road DS0000012762.V280139.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): 10. Residents’ confidentiality is maintained by good systems and practice within the home. EVIDENCE: Residents spoken with indicated that information relating to them is stored securely and treated in confidence. Residents have access to their records and fully involved in the discussions regarding their life, goals and expectations. Staffs demonstrated how they maintain confidentiality and were observed maintaining the residents right to privacy when they spoke to the Inspector. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 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 the following standard(s): 16. The residents feel valued by the respect shown to them by other residents and staff at the home. EVIDENCE: The residents have a set of “house rules” that have been agreed by all including the staff, which include individual responsibility to keep their bedrooms tidy. Residents spoken with indicated that they are actively involved in the running of the home and are responsible to specific tasks such as preparation of meals, hovering, and washing up. The personalised plans of care viewed for two residents being tracked showed their individual lifestyle, social interests and contact with family and friends is respected. The Inspector observed staff and residents speaking with each other in a respectful manner, giving time and space to the person speaking and not interrupting them. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 11 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. Residents continue to live independently with the support of staff to suit. EVIDENCE: Residents spoken with indicated that they are involved in the discussion about the care that is provided both at Debdale House and at the centres they attend. The two residents being tracked, showed the Inspector their individual care files, describing the type of information found in their file, showing how they have identified the level of support needed and their goals and aspirations. One resident has identified the goal of learning to prepare meals. Residents are encouraged and supported to maintain contact with family and friends visiting them and receiving visitors at home. All the residents have their own interests and are supported by the staff at the home to pursue these. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 12 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): 23. Residents are protected by staff that are aware of how to respond to any suspicion or allegations of abuse. EVIDENCE: Residents spoken with indicated that they felt safe and protected in the presence of the staff both within the home and whilst out in the community. Residents indicated that if they had any concerns they would tell their keyworker whilst identifying their key-worker on duty. The Inspector observed residents freely speaking with other residents and staff. The staff on duty was observed explaining to the resident how they would protect the residents from risks and potential abuse from within the home or out in the community. The residents have a set of house rules developed by them and the staff which is respected by all, which include no swearing and keeping your own bedrooms tidy. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 13 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, 26. Residents live in a homely environment that is in keeping with their choice of décor and lifestyle, although residents’ privacy should be improved. EVIDENCE: Entrance to the home is through the front garden, which appears to be overgrown, poorly maintained, and not in keeping with the neighbouring houses. Since the last inspection residents’ bedrooms have been painted and new carpets have been fitted to create a warm homely atmosphere throughout the home. Residents spoken with said they really enjoy being at home. The home is clean and decorated in a style chosen by the residents. The new double-glazed windows installed since the last inspection is still in keeping with the style of homes in the area. Residents spoken with have appreciated the new windows, and comments received included, “it’s much warmer now”. The Inspector viewed the shared bedroom of the two residents being tracked. It was noted that the broken wash hand basin identified as a requirement at the last inspection has still not been replaced. Additionally, there are no curtains in the bedroom, which compromises the residents rights to privacy. The Senior Carer on duty stated that the curtains have been
7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 14 measured but there was indication of when they would be fitted. The Senior Carer stated that the residents have were told to change in the bathroom, which was immediately questioned by one resident and furthermore on viewing the bathroom it was evident that there was insufficient space to change. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 15 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): EVIDENCE: The core standards were inspected at the last inspection and were met. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 16 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. The residents benefit from being involved in the running of the home and supported by staff that indicated that they receive regular training. EVIDENCE: The residents have formal residents meetings on a regular basis, which is an opportunity for concerns to be raised, learn about any planned repairs or changes to the home and an opportunity to discuss or plan the next holiday and short breaks for the residents. Residents spoken with appeared to be confident to speak with staff at any time if there is something that is concerning them. Staff on duty appeared to engage with all the residents and had a good understanding of the residents’ needs and risks posed to them. The Registered Manager was not on duty, which resulted in staff training records not being available to view. Additionally, the Inspector was unable to ascertain the number of staff qualified with NVQ qualifications. The staff spoken with indicated that they are offered training on a regular basis in conjunction with the staff at the other small home within the company. Since the last inspection the home has not recruited any new staff.
7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 17 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 X 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 2 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X 3 X X X X X X 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 18 Are there any outstanding requirements from the last inspection? YES 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. Standard YA24 YA26 Regulation 23 (2) (o) 23(2) (j) Requirement The front garden must be well maintained. The washbasin in the shared bedroom must be replaced. The timescale of 30/06/05 remains unmet. The residents’ bedrooms must have curtains fitted to the windows to maintain privacy. Timescale for action 25/02/06 25/02/06 3. YA26 16(2)(c) 25/02/06 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. Refer to Standard YA35 Good Practice Recommendations The Registered Manager should continue to pursue a training programme which will achieve 50 of care staff with Level 2 NVQs. 7 Debdale Road DS0000012762.V280139.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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