Inspection on 14/11/05 for 7 Manor Road

This inspection was carried out on 14th 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 no outstanding requirements from the previous inspection report, but made 9 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

7 Manor Road 14/09/07

7 Manor Road 09/08/06

7 Manor Road 27/06/05

7 Manor Road 08/02/05

7 Manor Road 17/08/04

7 Manor Road 15/03/04

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Polesworth Group 70 Long Street

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10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 7 Manor Road 7 Manor Road Stratford On Avon Warwickshire CV37 7EA Lead Inspector Martin Brown Unannounced Inspection 14th November 2005 15:30 7 Manor Road DS0000057990.V265146.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 7 Manor Road DS0000057990.V265146.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. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 7 Manor Road Address 7 Manor Road Stratford On Avon Warwickshire CV37 7EA 01789 414552 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) Turning Point Rosalyn Jane Taylor Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: 7 Manor Road is a care home operated by Turning Point. It provides a community based residential care service for five adults with profound learning disabilities. The home is situated in a residential area close to the town centre and local shops. The home is staffed 24 hours a day. The building consists of two converted semi- detached houses. This results in a degree of separation, with two staircases and a central fire door upstairs. There is a large kitchen, laundry and a separate staff office on the ground floor. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection of the year at this home, and should be read alongside the previous inspection report, for a fuller picture. Where key standards have been assessed on the previous inspection and have been seen to have been met, these have not necessarily been inspected on this occasion. The inspector was made welcome by the manager, staff, and service users, who were welcoming and helpful. The inspection took place over three and a half hours, in the late afternoon/early evening. All the people living in the home were present, save for one who was in hospital. What the service does well: What has improved since the last inspection? 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 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 6 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 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 7 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: These standards have been previously seen to be met were not looked at on this inspection. There have been no new admissions since the last inspection. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 8 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 Individual ‘food diaries’ supplement individual care plans to show in a clear simple way how needs are met. Care guidelines must be dated, to facilitate regular review and updating as required. EVIDENCE: These standards were met at the last inspection, with progress being checked on individual plans on this occasion. The ‘food’ diaries were seen for a number of residents. These are simple clear, user-friendly guides, relying on photographs and straight forward explanation to show people’s food preferences and what help they might need. They are being extended beyond food and eating and into all relevant areas of a person’s life, and form a useful guide to anyone unfamiliar with that person’s needs and wishes. Looking at these prompted one service user to fetch out her recent photo book, of which she was obviously very proud, showing the enjoyable time she obviously had at her fiftieth birthday party. Individual guidelines for care were seen. Although these were good, in some instances these were not dated; nor was it clear who had written them. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 9 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): 14,17 Now there is sufficient staffing, forward planning should enable suitable holidays for residents to take place. Mealtimes continue to be an enjoyable, positive event. EVIDENCE: People living at 7 Manor Road continue to enjoy a variety of activities in line with their needs and wishes. Staff shortages noted during the previous inspection had prevented holidays being planned, and was the subject of a requirement. The manager advised that two residents had had a short break in a hotel, and that one service user had had a holiday with the club he attends. It is an expectation that suitable holidays will be arranged where appropriate in the coming year. Menus and observations during the evening meal confirmed that residents continue to enjoy healthy and varied food in a relaxing atmosphere. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 10 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 These standards continue to be met. A larger permanent staff group is now better able to ensure a consistent approach to meeting support needs. EVIDENCE: One service user is currently very poorly in hospital, and staff are obviously concerned for him, and cover is arranged so that staff are able to be present at the hospital for much of the time, to give him additional support. One service user had a seizure at meal time; this was dealt with calmly and competently by staff, with the minimum of fuss, helping to ensure that a calm helpful and sympathetic atmosphere prevailed. Outside specialist support is being utilised where appropriate, relevant information is being recorded to assist specialist support. Administration of medication was seen to be satisfactory on the last inspection; it is noted that there is now a larger number of staff who are able to administer medication. There is likely to be a change in night care, with a service user’s changing needs resulting in having waking night staff. The manager acknowledged that the night time policy, and the cross-gender care policy consequently require updating to prepare for this eventuality. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 11 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 Action taken by the home to meet a previous complaint, in conjunction with meeting inspection requirements, is having a positive impact for service users. Updating care policies in the light of anticipated changes in care needs will help ensure service users are protected. The protection of people in the home will be severely compromised if recruitment procedures are not followed. EVIDENCE: The previous complaint noted is being addressed, by improvements in staffing, and to the house and grounds. Positive comment cards were received from relatives. The cross-gender care policy is to be further amended, to take account of changing care needs. The home was not able to produce written evidence that a satisfactory Criminal Records Bureau check had been received for one member of staff. This was made an Immediate Requirement and is dealt with more fully under standard 35. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 12 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): 24,25,27,28 The environment is being improved; the overall, cosy, homely feel was greatly compromised by most rooms upstairs being cold. EVIDENCE: The dining room and office have been repainted and refurbished, largely due to the manager’s own efforts. There is still work to be done in the dining room, but it is now much more attractive. The lounge and hallway is still to be refurbished, the manager was able to show me plans for these to be done, with clearance for funding, and identified persons to carry out the work. Outside work, notably the facias, and the garages, are still to be done; broad agreement on responsibilities for doing this work has now been reached. The small room by the front door is a very effective sensory room and was being enjoyed by one resident in the evening. Staff advised that it is enjoyed at different times, by most service users. Although the house was warm downstairs, radiators upstairs were found either to be giving out insufficient heat to warm rooms, or to be giving out no heat at all. The radiator switch on the upstairs radiator came off in my hand. An immediate requirement was issued to have these attended to. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 13 Staff spoken to at the time queried whether there was a blockage, or air pockets, in the system, or whether the boiler was insufficient to properly heat what is, in effect, two houses. One service user who was in his room and was able to respond said he was quite warm enough, although his room also seemed rather cool. Individual bedrooms continue to be attractively furnished, reflecting individual personalities. Radiators do not have protective covers on them, presenting a potential risk in the event of them being hot. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 14 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,33,34,35 Staff morale has greatly improved as the number of permanent staff has increased. This is enabling staff training to take place in a more organised manner, more activities to be planned for service users, and for the manager not to be personally covering shifts so often. Safe and effective recruitment procedures are compromised by the lack of clarity on evidencing safe clearance of staff. EVIDENCE: There were five staff, including the manager, present during the inspection. Staff are also supporting the gentleman currently in hospital. The rota shows the deployment of a lot more permanent staff. Staff spoken to were positive and optimistic about training, saying that they are now having much greater training opportunities. This was confirmed by the staffing matrix. However, two staff who have been in post for over six weeks have still not had their induction training. The manager advised that these staff are to undertake Learning Disability Award Framework training. Dementia training for staff has not taken place. The manager advised that this was because the identified trainer had not been forthcoming with a course, and that alternatives were now being sought. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 15 A sample of recruitment files were looked at. One file did not have any written evidence of a satisfactory Criminal Records Bureau check. The manager advised that she had been given verbal clearance from Turning Point Human Resources, but had received nothing in writing. An Immediate Requirement was made to produce written evidence that a satisfactory Criminal Records Bureau check has been received. Other Criminal Records Bureau checks were able to be evidenced. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 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): 37,42 Higher levels of permanent staff will enable the manager to concentrate more fully on running the home. Priority tasks are ensuring appropriate recruitment checks are evident and that all maintenance and refurbishment takes place. EVIDENCE: Staff spoken to were positive about the improvements in the home over the past few months, principally as a result of there being more permanent staff in place. The manager felt she is now able to concentrate more on management tasks, and to better ensure the effective running of the home. Magnetic closures are now in place on identified doors in accordance with the fire officer’s advice. There is a potential risk from hot radiators. 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 x 3 3 x x LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score x 3 3 2 2 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 7 Manor Road Score 2 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x DS0000057990.V265146.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA14 YA18 Regulation 16(2) 13(6) Requirement That suitable holidays are arranged for service users over the coming year. Night time care and cross gender care policies require updating to take account of changing circumstances. Repair and refurbishment is to continue The home must ensure that radiators work effectively to maintain an acceptable temperature throughout the home. Risk assessments must be produced for all radiators, and they must be made safe accordingly. The home must have written evidence that satisfactory Criminal Records bureau checks have been undertaken for all staff. All new staff must undertake a suitable induction process within six weeks of appointment. Guidelines regarding personal care, must be dated and signed, to facilitate their review and updating. DS0000057990.V265146.R01.S.doc Timescale for action 19/05/06 19/12/05 3 4 YA24 YA24 16,24 23 19/01/06 19/11/05 5 YA42 23 19/12/05 6 YA34 19 19/11/05 7 8 YA35 YA6 18 15 18/12/05 18/12/05 7 Manor Road Version 5.0 Page 19 9 YA35 18 The home must ensure appropriate dementia care training is undertaken. 18/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 7 Manor Road DS0000057990.V265146.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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. 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