Inspection on 27/06/05 for 7 Manor Road

This inspection was carried out on 27th June 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

7 Manor Road 14/09/07

7 Manor Road 09/08/06

7 Manor Road 14/11/05

7 Manor Road 08/02/05

7 Manor Road 17/08/04

7 Manor Road 15/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

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 3.30pm 27 June 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 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 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 Jane Taylor PC Care home only 5 Category(ies) of LD Learning disability (5) registration, with number of places 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 8 February 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 dgree of separation, with two staircases and a central firedoor upstairs. There is a large kitchen, laundry and a separate staff office on the ground floor. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced visit lasting just over three hours on a weekday late afternoon/early evening. Staff, manager, and service users were welcoming, friendly and helpful. What the service does well: What has improved since the last inspection? What they could do better: More individual and development work could be done by the home, but at present it is hampered by only having three permanent staff. A lot of the good work currently d being done in the home relies on the goodwill and effort of the current staff team, including long-term agency workers. The organisation needs to build on this to ensure that staff are retained and added to, or risk this good work being lost, rather than developed. Time and money also needs to be spent on refurbishing the home. The organisation’s Human Resources department needs to ensure its recruitment procedures are not discouraging potentially good staff from becoming permanent. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: There have been no new service users for over two years, and the home currently has no vacancies. These standards were met at the previous years’ inspections and were not fully looked at on this occasion. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7,8,9 Clear, accessible plans and assessments help staff to support service users in their everyday lives. Where service users have difficulty in communicating wishes and needs, staff experience of them, combined with clear guidelines, help in mutual understanding. Daily records could more usefully focus on noteworthy events and achievements, rather than recording daily events for the sake of it. EVIDENCE: The home is producing accessible and clear ‘communication passbooks’ and ‘food diaries’ for each service user. These are, in essence, guidelines for service users, that help staff in understanding what help needs to be given to people living at the home to get what they want, and what they need. The ones seen so far are clear and simple, highlight the areas of greatest importance, and are well-illustrated with photographs. Daily diaries are filled in for each service user, detailing such things as what has been eaten for breakfast. The manager advised that staff support service users in making decisions, and use their knowledge of service user preferences, along with communication guides, to help inform decisions. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 10 Much work has been done with outside agencies with one service user whom it was thought might wish to move on to more independent living. He has made it clear, as he did on this inspection, that he wished to stay at Manor Road. Risk assessments are in place. A lot of the more individual and specific risks are covered most clearly and simply in personal guidelines for individual service users. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,16,17 The home supports people living there to take part in activities they wish to, but higher levels of permanent staffing would enable more individual activities and more planned personal development work to take place. It is not acceptable that some service users should be deprived of the opportunity of a holiday because of uncertainties over whether there will be sufficient staffing available. EVIDENCE: Service users have a mixture of regular and occasional activities, some, in the day, involving outside agencies. One service user regularly attends college, two others have regular day services. Two service users have activities largely based from the home; they had both been out earlier for a pub lunch. One service user has a fiftieth birthday coming up; the manager advised that special events are planned for this. The manager advised that a shortage of permanent staff hampered the fuller provision of meaningful activities; particularly planning for future activities 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 12 such as holidays. Two service users had planned holidays; one with parents, one with the local Gateway club. The home had not yet been able to plan any holiday for the other three service users, because of the uncertainties of staffing cover. Service users enjoyed their evening meal together; as with other aspects of the home, it appeared a relaxed, homely, easy-going event. Menus and food stocks demonstrated a good provision of a varied and nutritious diet. Food diaries and communication aids, combined with staff knowledge, helped service users’ wishes to be catered for. One service user was able to show me evidence of his activities, talk to me about what he had done lately, and was very positive about his life at the home where he had lived for the last five years. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Service users have their personal needs met predominantly by a staff team who are familiar with them and who are able to meet those needs in a positive and sympathetic way. A larger permanent staff team would result in less reliance on agency staff less familiar with the service users’ needs. EVIDENCE: Staff gave personal support in a positive, unobtrusive manner, demonstrating a thorough knowledge of the needs of the people living at the home. Clear guidelines are in place for personal support; the staff on duty were all experienced staff who knew the guidelines and who had been, in most instances, been involved in drawing them up. Outside professional support from speech and language therapists, occupational therapists and physiotherapists is accessed by the home, and individual needs were catered for. Medication was administered and recorded correctly, within clear and simple guidelines, with medication stock control being aided by medication being received in 28 day supplies, pre-packed as far as possible. There is a helpful medication profile, clearly stating the need for each medication; unfortunately, the name of one medication had recently changed, and had yet to be updated on the profile. The manager advised that she would update this. Only the three permanent staff are able to administer medication; 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 14 the manager advised that long term agency staff are to undertake training to enable them to be able to administer medication. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 Service users are supported by policies, staff and significant others in having concerns raised and in being protected from harm. The organisation needs to ensure it addresses general concerns raised. An update of the policy as mentioned below will further enhance this. EVIDENCE: The complaints log showed one recent complaint, from parents of people living in the home, concerning staffing, the garden, and the decoration of the home. This was no evidence that this had yet been responded to by the organisation. Communication books and the approach of staff and the manager demonstrate a genuine attempt to understand and respond to service users’ day- to- day needs and wishes. One service user has had outside support in investigating possible living alternatives. Relatives and outside agencies, as well as the home, are involved in the lives of service users; communication guides support the abilities of service users to make clear when they are unhappy with something. There is a cross-gender policy in place, to cover the possibility of a male staff having to provide personal assistance for a female service user. The manager agreed that this required updating. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 The house provides a homely and reasonably comfortable environment, but at present, this is very much compromised by the urgent need for redecoration and refurbishment, both inside and out. EVIDENCE: The kitchen has been refurbished, but the stop cock has still to be moved to a more accessible point, after which the flooring is to be completed. The laundry now has a new flooring. Redecoration is overdue throughout the house; scratches, marks and stains are evident throughout the house on walls and carpets. The dining room has bare plaster on one wall where a window was filled in between the office and the dining room. The home now has a contracted gardener. The garden, particularly the front garden is a very attractive feature which staff have, in the past, worked hard on. The rear garden in particular, is still a little overgrown. Outside paint work and facias, along with the garages, also require attention. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36. Whilst the existing staff showed themselves to be skilled and knowledgeable, the permanent staff team of three is far too small to be able to fully meet the needs of the people living at the home without a heavy reliance on extra hours or agency and bank staff. EVIDENCE: The staff on duty during the inspection were all familiar with the service users and able to assess and meet their needs and wishes. Rotas showed a heavy reliance currently on bank staff and agency staff, or on permanent staff working additional hours. The manager advised that one person had been recruited recently, but had left almost immediately, and felt that recruitment done at a more local level might be more effective. Records of regular supervision and team meetings were seen. Appropriate records were seen in respect of the use of agency staff. At present, staff training is constrained by difficulties in providing experienced staff cover. Distance learning is being used for food hygiene and further medication training. The manager advised that required training on dementia is to take place in September. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,42 Additional permanent staffing would free the management to concentrate more on development and management of the home. Issues are being raised at parents’ meetings that are not then being satisfactorily dealt with. Service users’ safety in the event of a fire is at present compromised by the lack of a clear policy and procedure for night time, and a need for magnetic closures on all doors used as thoroughfares. EVIDENCE: There are regular meetings held with parents of the people living at the home where issues of concern are raised. The manager advised that parents are frustrated with what they see as a lack of action on key issues such as the home being refurbished and more permanent staff being appointed. The manager also strongly felt that she was having to spend much of her working hours covering shifts in the home, resulting in very limited time being available to her for undertaking management and development tasks. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 19 ‘Communication passports’ and ‘food diaries’, alongside regular staff’s knowledge, and guidelines in individual files, help ensure service users’ views are understood and taken into account. Fire procedures were discussed with staff; whilst the day time procedure was clear, a staff member stated that there had been differing advice from fire officers as to whether evacuation or isolation is the better procedure for night time. Some fire doors downstairs had magnetic fire closures on; others had not. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 20 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 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 3 2 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score 2 2 2 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 7 Manor Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x x 3 x E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 21 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 31,32,33 Regulation 18 Requirement The numbers of permanent staff must be increased, to reduce the reliance on agency staff, bank staff, and on existing staff working excessive hours. Such an increase will also allow for the provision of holidays for service users, and for the manager to spend an appropriate time on management functions. The cross gender care policy is to be updated. The organisation is to respond to the logged complaint concerning staffing and redecoration A redecoration and refubishment schedule is required, detailing how and when required work is to be done. The home must clarify with the fire officer its night time fire policy, based, if necessary, on individual service user risk assessments. The home must audit all its downstairs doors and thoroughfares, with the fire officer if necessary, to detrermine how many more doors require magnetic door Timescale for action 4/8/05 2. 3. 4. 23 22 24 13(6) 22 16,24 4/8/05 4/8/05 4/8/05 5. 42 23(4) 4/8/05 6. 42 23(4) 4/8/05 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 22 releases. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 6 Good Practice Recommendations It is recommended that any daily, or regular, recording focuses on noteworthy achievements or events, which should form part of individual life story books. 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection 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. Extracts may not be used or reproduced without the express permission of CSCI 7 Manor Road E53 s57990 7 Manor Rd v235550 270605 Stage 4.doc Version 1.40 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!