Inspection on 01/11/05 for 7 Eworth Close

This inspection was carried out on 1st November 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

7 Eworth Close 03/09/09

7 Eworth Close 24/07/07

7 Eworth Close 24/07/06

7 Eworth Close 19/07/05

7 Eworth Close 22/09/04

7 Eworth Close 16/03/04

7 Eworth Close 03/11/03

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 Eworth Close (7) 7 Eworth Close Grange Park Swindon Wiltshire SN5 6BT Lead Inspector Bernard McDonald Unannounced Inspection 1st November 2005 08:30 Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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 Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Eworth Close (7) Address 7 Eworth Close Grange Park Swindon Wiltshire SN5 6BT 01793 878169 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) Ian Charles Mrs Maria Arthur Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. No more than five service users with learning disability at any one time Date of last inspection 19th July 2005 Brief Description of the Service: 7 Eworth Close is a modern two storey house with a large garden. The home offers care and accommodation to both men and women who have a learning disability. The service replicates principles of ordinary living and strives to provide services that take account of ‘social role valorisation’ principles that include choice, dignity, respect and community presence. Each service user has their own bedroom and share communal areas. The service is designed for people that can manage stairs and want to live with others. Any behaviour’s must be manageable within a small domestic environment. The home, which is located in the Grange Park area of Swindon, is a partnership that trades as Ian Charles. They have one other similar care home nearby. There is a full time manager and a small staff team. Typically there is one person on duty throughout the day with an additional member of staff on duty between 10.30am and 8.00pm. At night time the staff take in turns to sleep at the home and to be available to assist with any nighttime needs or emergencies as they arise. Service users are expected to engage in day activities during the week. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out over six hours. The inspector met with three service users in private and in small groups to obtain their views on the care they receive. The inspector viewed all areas of the home including all service users bedrooms. In addition the inspector met with two support staff. The inspector examined all service users care plans, policies, procedures and health and safety records. In the absence of the manager the requirements relating to safe recruitment practices could not be inspected. These requirements will be brought forward to the next inspection. The remaining requirements made at the last inspection had been met. Following the last inspection the Commission served two statutory enforcement notices due to continued none compliance with requirement made in previous inspection reports. This inspection found the requirements of the notices had been met. What the service does well: What has improved since the last inspection? The home has improved a number of documents and polices following requirements and recommendations made at the previous inspection. These improvements have a direct effect on service users living at the home. Contracts have been improved and made available and explained to service users to ensure they are aware of the terms and conditions of their stay. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 6 A holiday policy has been developed to clarify who pays for the holiday, what consents are needed and the level of staff support. Discussion with service users confirmed they were looking forward to going away but had not yet chosen the destination. The home has met the statutory enforcement notices and developed a quality audit to obtain the views of service users about the care they receive. The format for the review is in place but now needs to be implemented. In addition, portable appliance testing has been completed to ensure electrical equipment is safe for service users. 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. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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 Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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): 3, 5. Service users have been informed of the terms and conditions of their stay. EVIDENCE: There have been no admissions since the last inspection. Previous inspections found the home was ensuring service users needs had been assessed prior to admission. A trial placement is offered as part of the introductory process. Following a requirement made at the last inspection the registered person provided the Commission with a copy of the homes standard form of contract. Discussion with two service users confirmed they have seen the contract and the contents had been explained to them. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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, 10. The home is ensuring service users needs and aspirations are met and that that their confidences are being kept. EVIDENCE: Each service user has been supported to develop a person centred life plan that forms the background to the service user care plan. Two service users showed the inspector their life plans. The documents were sensitively written and explored service users feelings, wishes and aspiration. The inspector examined the care plans of all service users. Discussions with two service users confirmed their involvement in developing their care plan and attending care review meetings. Care plans identified goals and outcomes for service users and what steps staff need take to support service users. Discussion with two support staff demonstrated an understanding on how to meet the needs of service users. Discussion with service users confirmed they had access to their files and records. Staff demonstrated an awareness of the principles of confidentiality Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 10 and what information can be shared between the home and other professionals. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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): 11, 14, 17. The home ensures service users are supported to participate in community activities and provided with a healthy diet. EVIDENCE: Service users care plans identify how they are supported in maintaining and developing independent living skills. One service user stated that staff help them with their personal laundry, keeping their room tidy and helping to plan and prepare meals. Service users spiritual needs are being met at the home. One service user is supported to attend a church service each Sunday. One service user said they did not want to go to church. Opportunities are provided to support service users access the local and wider community. Daily records show that service users visit local markets, have trips into town and are going to the firework display at the weekend. Following the last inspection an escalated warning letter was sent to the home to ensure a policy is developed on holiday provisions for service users. The Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 12 inspector found the requirement had been met and service users spoke enthusiastically about where they were going on holiday next year. Service users confirmed they were involved in developing the weekly menu. The main meal of the day is provided in the evening and one service user confirmed that if they not like the meal an alternative would be provided. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 20. The home is ensuring service users receive support in a way they prefer but is failing to ensure staff are sufficiently trained to administer medication in a safe manner. EVIDENCE: There is a flexible approach to routines at the home. Service users confirmed they choose when they get up and go to bed. Records examined demonstrate service users specialist needs are being met and that they have access to speech therapy and psychiatric services. Examination of medication records demonstrated medication was being recorded when received at the home. However there were a number of gaps in the record of medication administered to service users. The inspector could not determine whether medication had been refused or not given. Discussion with the deputy manager confirmed training is given, but, from discussion with staff training is through observation and is not sufficient to ensure staff are competent to safely administer medication. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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 the following standard(s): 22, 23. The home is making every effort to ensure service users views are listened to and they are protected from abuse. EVIDENCE: The deputy manager confirmed no complaints have been received at the home since the last inspection. Discussion with one service user confirmed they would tell staff if they were unhappy about anything, though were quick to point out they were happy living at the home. The complaints procedure was available in the home and specified any complaint would be responded to in twenty-eight days. Discussion with staff demonstrated an understanding of what constitutes abuse and what action they would to report any concerns that affect the welfare of service users. A whistle blowing policy is in place to support staff in reporting any concerns or bad practice at the home. Following a requirement made at the last inspection the manager has put forward the names of all staff to complete abuse awareness training. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 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 the following standard(s): 24, 30. The home provides service users with a comfortable and safe environment but is failing to ensure staff receive training in infection control. EVIDENCE: The home is situated in a quiet residential development in the Grange Park area of Swindon. Accommodation is split onto two floors with two service users bedrooms on the ground floor and three bedrooms on the first floor. In addition there is a staff sleeping in room on the first floor. The inspector viewed all areas of the home including all service users bedrooms. The home was clean, tidy, free from odour and reasonably maintained. There was an enclosed rear garden that has recently had new fencing erected to ensure service users safety when they access this area. Parts of the home were beginning to show signs of wear especially in the hallway and stairs. The deputy manager confirmed there is a renewal programme in place to decorate all areas of the home over the coming year. The inspector found staff had not received infection control training. It is a requirement that this is now provided to ensure staff are aware of what action they must take to reduce the spread of infection at the home. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 16 It is further recommended that the manager contacts the health protection agency and obtain a copy if the new infection control guidelines. Two service users are supported with their personal laundry. The washing machine and dryer are domestic in style and sufficient for the needs of the home. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 17 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): 33, 34, 35. Though service user appear satisfied with the care they receive the home is failing to ensure staff are sufficiently trained to meet their needs. EVIDENCE: Examination of the rota demonstrated there are normally two staff on duty from 10.30am to 8.00pm. Outside of these hours there is normally one staff member on duty. Service users commented that they liked the staff and one services user commented that they were “wonderful”. This is a small care home were care is provided in a family style setting. Observations made during the inspection found interactions between service users and staff were relaxed and support was being offered in a sensitive manner. Staff meetings are normally held every six weeks but due to the recent turnover of staff these meetings have been neglected. In the absence of the manager staff recruitment records were not available. The two requirements made at the last inspection will be carried over. The registered providers visited the home for part of the inspection and confirmed that a POVA first check had not been received on one member of staff. The owners had been in contact with the body that undertakes their criminal records bureau checks and a copy will be forwarded to the Commission to demonstrate this check has been received. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 18 Discussion with one member of staff highlighted that they had no training other than first aid in the last two years. This is unacceptable and action must be taken to develop a training plan for all staff to ensure they receive a minimum of five days training that will ensure the specialist needs of service users are clearly understood and that their care is safely met. This was a recommendation at the last inspection. One member of staff recently employed is to attend a formal induction course that is “skills for care” accredited at the local college. In addition a checklist has been developed to ensure the in house induction programme is monitored. As part of the induction all new staff are shadowed by an experienced member of staff. The deputy manager stated that all new staff are enrolled on the learning disability award framework training (LDAF). Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. The home is failing to ensure service users health, safety and welfare is protected. Action is being taken to ensure service users views are listened to. EVIDENCE: The deputy manager confirmed, that, together with the manager they had registered to complete the registered managers award and NVQ4 in care. Following the last inspection an enforcement notice was issued to ensure an effective quality assurance system was implemented at the home. In response to the notice the registered providers have purchased a package that will review policies, procedures, documentation and the service provided at the home. The package will seek to obtain the views of service users stakeholder and relatives. The outcome will then be incorporated into the development plan for the home. Though in its infancy the quality assurance package should provide clear evidence on how the it is meeting the needs of service users and the aims and objectives of the home. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 20 A second enforcement notice was issued to ensure portable appliance testing is completed by a person who has the relevant knowledge and skill. The inspector found the enforcement notice had been met. One service user confirmed they were aware of what to do in the event of a fire. However the inspector found that safety checks on the fire alarm and emergency lighting were not taking place. In addition the last recorded fire safety practice was held in June 2005. To ensure the safety of service users the inspector asked for the fire alarms to be tested immediately and that a fire safety drill is completed within one week. The inspector was advised water temperatures are regulated in the bathroom and shower close to 43c and that the temperatures are checked regularly but not recorded. It is recommend a record is kept of these tests. Other hot water outlets are not regulated and this is supported by a risk assessment. In addition radiators are not guarded, as this has been risk assessed as acceptable. The inspector found the widows above the first floor did not have restricted openings. It is a requirement that risk assessments are complete and action must be taken where any risk to service users is identified. The inspector is concerned that these basic safety measures have not been completed at the home due to risk assessments being completed. While it acceptable not to put these measures into place if there is no risk to service users this practice relies heavily on the risk assessments being sufficiently robust to ensure the safety of service users. It is a requirement that the home reviews all risk assessments relating to the safety of service users and where necessary take action to protect service users. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 21 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 X X 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 2 LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 2 2 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Eworth Close (7) Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score 2 X 2 X X 2 X DS0000003195.V262444.R01.S.doc Version 5.0 Page 22 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 YA20 Regulation 13(2) Requirement The registered person must ensure staff have received training in the safe handling of medication and can demonstrate staff are competent to administer medication to service users. The registered person must ensure staff receive training in infection control. The registered person must ensure no staff are employed to work in the home unless the home has first received a satisfactory CRB at enhanced level that the home had requested as part of their pre employment checks. This requirement has been carried over from the previous inspection due to records not being available. The registered person must ensure all documents specified in Schedule 2 of the Care Homes Regulations 2001 are received on each member of staff prior to them commencing employment at the home. This requirement has been DS0000003195.V262444.R01.S.doc Timescale for action 01/12/05 2 3 YA30 YA34 13(3) 19(1)(a) (b)(i) 01/04/06 01/08/05 4 YA34 19(1)(b) 01/08/05 Eworth Close (7) Version 5.0 Page 23 5 YA35 18(1)(a) (c)(i)(ii) 24(2) 13(4)(a) (c) 6 7 YA39 YA42 8 YA42 13(4)(a) (b)(c) 9 YA42 23(4)(c ) (v)(e) carried over from the previous inspection due to records not being available. The registered person must ensure care staff receive a minimum of five days paid training a year. The registered person must provide the Commission with a report of their quality review. The registered person must complete a risk assessment on window openings and where a risk is identified action must be taken. The registered person must review all risk assessment relating to the safety of service users, paying particular attention to hot water temperatures and radiator covers. The registered person must ensure fire safety drills are completed a minimum of every three months and that a fire safety drill is completed by 8/11/05 01/04/06 01/04/06 01/12/05 01/01/06 08/11/05 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 3 Refer to Standard YA30 YA33 YA35 Good Practice Recommendations The registered person should contact the health protection agency to obtain a copy of the revised infection control guidelines. The registered person should ensure staff meetings are held a minimum of six times per year. The registered person should develop a staff training and development plan. The purpose of the plan is to ensure staff receive training appropriate to the needs of service users. Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Eworth Close (7) DS0000003195.V262444.R01.S.doc Version 5.0 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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