Inspecting for better lives Key inspection report
Care homes for adults (18-65 years)
Name: Address: 7 Debdale Road 7 Debdale Road Wellingborough Northants NN8 5AA The quality rating for this care home is:
two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Keith Williamson
Date: 0 8 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 25 Information about the care home
Name of care home: Address: 7 Debdale Road 7 Debdale Road Wellingborough Northants NN8 5AA 01933276930 01933229606 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Ms Catherine Denise Arnold Type of registration: Number of places registered: Care Management Group Ltd (trading as CMG Homes Ltd) care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: 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 catergory. Date of last inspection Brief description of the care home 7 Debdale Road provides care for up to five adults with a learning disability. The home is situated close to Wellingborough town centre and is close 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 large rear garden. All current Service Users are accommodated in single rooms. Previously there were two residents sharing a bedroom, but one bed has been removed. Communal areas consist of a lounge and a dining room. The current fees range from £564 to £795 per week. All Service Users receive funding from Social Service Departments. There are costs for Care Homes for Adults (18-65 years)
Page 4 of 25 Over 65 0 5 Brief description of the care home extras such as hairdressing, toiletries, holidays, daily papers and magazines. The homes Statement of Purpose and last Inspection Report are available on request. The Service Users Guide is provided to Service Users and copies available on their files. Care Homes for Adults (18-65 years) Page 5 of 25 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home
peterchart Poor Adequate Good Excellent How we did our inspection: The focus of inspections is on outcomes for Service Users and their views of the services provided. The main method of inspection used was case tracking which involves selecting a sample number of clients and tracking their care they received through talking with them, where possible and looking at their records and accommodation, in this case one Service User was chosen. This visit took place over one day, commencing at 10.30pm and took five hours to complete. An opportunity was taken to talk with the Manager staff, look around the home, view records, policies and care plans. Information was also obtained from the Annual Quality Assurance Assessment, which gives information on the Service Users, home and the staff group. Care Homes for Adults (18-65 years)
Page 6 of 25 Two staff were spoken with, and two Service Users were seen, and their interactions with the staff group observed. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. What the care home does well: What has improved since the last inspection? The staff are improving the care plans and adapting the style to a more person centered approach. Issues from the last inspection included the tumble dryer and dishwasher, which were both replaced. The walls in the dining room are part of the ongoing decorating programme, and downstairs toilet has been redecorated. The spare bed that was identified, has now been removed and curtains were put up at the windows. Staffing has increased, and this has enabled Service Users to pursue their own interests. Care Homes for Adults (18-65 years) Page 8 of 25 Risk assessments were carried out on all hot water radiators, and many have protective covers put in place. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 9 of 25 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 10 of 25 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A thorough assessment procedure ensures that service users needs are effectively met. Evidence: The service users assessment information was well detailed and contained information relating to their needs and abilities. This is important as this information forms the basis for any plan of care. Some of the assessment details had been updated, though the person had been resident for a significant period of time, and the details did not accurately reflect their current abilities. A contract was also in place. These documents are important to signify the terms and conditions of their stay. Discussion with the registered manager and staff indicated that the assessment process was being changed to a person centered style. This shows the staff are giving more thought to the detail in the assessment process. Care Homes for Adults (18-65 years) Page 11 of 25 Individual needs and choices
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service Users are supported by a well informed staff group, backed up be detailed care plans and risk assesments. Evidence: The Service Users support plan was examined: this like their assessment was well detailed and covered areas in their daily life. The plan was written in a person centred way, and bore a direct link to the assessment information. Care plans are being adapted into Person Centered Plans (PCP), this shall improve the details in the plan and shows the home developing the information needed to care for people. The care plan was signed by the Service User, indicating their agreement with the content. Staff responsibilities for meeting various aspects of the plan were clearly identified and there was evidence that the information was regularly reviewed. The plans were backed up by risk assessments these giving staff instruction on how to care for people safely. Staff displayed a good understanding as to why this was appropriate. Daily notes cover activities and the
Care Homes for Adults (18-65 years) Page 12 of 25 Evidence: Service Users responses. Care Homes for Adults (18-65 years) Page 13 of 25 Lifestyle
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People at the home experience good lifestyle choices. Evidence: Service Users personal development is detailed in care and Person Centred Plans (PCP). People living at the home, have paid employment, attend college and day centres. Service Users take part in leisure activities both within and out of the home. Somthing new which has been introduced, is where people have a free choice of activities, and spend time with their chosen member of staff. This allows the Service User to have one on one time to plan a range of activities suited to them. Service Users have the option of bedroom keys. The planning of meals is an area, where Service Users again have a direct input, where meals are planned around peoples likes and dislikes. Care Homes for Adults (18-65 years) Page 14 of 25 Care Homes for Adults (18-65 years) Page 15 of 25 Personal and healthcare support
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service Users health, personal care and medication needs are well met. Evidence: Service Users personal care and support needs are clearly detailed in their care plan; this is detailed and indicates likes and dislikes such as which staff members they preferred to receive support from. Service Users also have information in their plan of care, about their health management and have regular access to dental and optical services. Other specialists such as psychiatrists, psychologists and speech and language therapy staff also have individual input. This is important as it shows the home cares for peoples greater health needs. Medication is safely administered, with a senior member of staff overseeing the regular audits and day to day checks in place, so ensuring peoples safety in the home. Care Homes for Adults (18-65 years) Page 16 of 25 Concerns, complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users are protected by policies, procedures and a well informed staff group. Evidence: There have been no complaints forwarded to the Commission for Social Care Inspection with regard to the home. There has been one complaint recorded by the staff, which was dealt with promptly. Complaints information is clearly displayed in the Service User Guide, and in the home, as well as being available in a pictorial version. This will help the current Service Users in making a complaint. Information on advocates and advocacy services are also freely available in the home. The information enclosed in the complaint documents is not up to accurate, and needs to be updated. This shall give the correct information for people to act on. Service Users and staff told the Inspector what they knew about the complaints, adult protection and whistleblowing procedures. They all showed a good understanding of the process involved in following such issues through. Care Homes for Adults (18-65 years) Page 17 of 25 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users live in an environment that is homely, comfortable and clean Evidence: The general decor is good with the dining room being decorated at the time of the visit. The manager shared details for a planned re-fitting of the kitchen and laundry area. Though there is currently no maintenance and refurbishement plan for the home, it is clear that the home is updated and re-decorated on a regular basis. The Service Users bedrooms are personalised, with various pictures furniture and electrical equipment. Staff were aware of cross contamination and cross infection issues, and agreed that there were plentiful supplies of protective clothing. This is important as it protects people in the home. There are two areas for improvement, where the heating is at a poor level on the ground floor, a re-assesment of the radiators is neccesary. The door locks to the public rooms need to be rmoved or blanked off. This is to ensure the safety of people in the home. Care Homes for Adults (18-65 years) Page 18 of 25 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service Users are supported and protected by well-trained staff and effective recruitment practices. Evidence: Staffing levels reflect the Service Users level of need and enable individual support throughout the day and night. A comprehensive programme of training is in place with courses planned throughout the next six months. Staff spoke positively about the training opportunities and the ongoing, individual support that they receive, one stated we always do the statutory courses every year. Training is arranged through private and public providers. Staff recruitment records were examined; these were up to date and in order. These contained a written application form, two written references and evidence of identity. Discussion was held about Criminal Records Bureau checks and the delay currently experienced with these being processed. Staff supervision is undertaken regularly, and assists the manager plan appropriate staff training. This is important as it means staff are viewed on an individual basis, and the appropriate training planned accordingly. Care Homes for Adults (18-65 years) Page 19 of 25 Conduct and management of the home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are protected by a system in place that recognises the importance of safety in the home. Evidence: The current manager has now been registered with the Commission for Social Care Inspection (CSCI). Quality Assurance (QA) which is the way the homes success is measured, is seen as important with questionnaires and other initiatives being performed on a regular basis. This is done by a person appointed by the company, and is therefore independent from the home. This is good as the findings are independent of any staff influences. Visits are made by the regional director, who oversees the development of the manager, staff and safety of the home, this is yet another area of Quality Assurance. The policies and procedures in the home are developed and updated on a regular basis by the head office of the company. A computer system is currently being installed which should enable easier access to updated versions of these, and other documents.
Care Homes for Adults (18-65 years) Page 20 of 25 Evidence: The overall safety within the home is excellent, with regular and detailed checks in place in a number of areas looked at on the day. Care Homes for Adults (18-65 years) Page 21 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards
No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 22 of 25 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 22 17 The responsible person must 07/04/2009 ensure that the complaint information is updated to include the correct details. This is to ensure that people have the correct information and contact details to enable them to make a complaint. 2 24 23 A plan for the refurbishment and replacement of items in the home is required to be put in place. This is to ensure areas requiring to be attended to are done so in a timely manner. 07/04/2009 Recommendations
These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 All Service Users needs could be re-assessed. This would ensure that any assesments reflect the latest abilities of the Service User. Care Homes for Adults (18-65 years) Page 23 of 25 2 3 24 24 It is recommended that the heating needs in the home are re-assessed, and appropriate action taken. It is recommended that the handle door locks that are no longer used, are removed or blanked off, to ensure the safety of people in the home. Care Homes for Adults (18-65 years) Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 25 of 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
