CARE HOME ADULTS 18-65
75 - 77 Wickstead Avenue Luton Beds LU4 9DW Lead Inspector
Paul Worthy Unannounced 08 August 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. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 75 - 77 Wickstead Avenue Address Luton Beds LU4 9DW 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) 01582 504217 Mencap care home 5 (5) Category(ies) of LD - Learning Disability registration, with number of places 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 14/03/05 Brief Description of the Service: 75 - 77 Wickstead Avenue provides accommodation for five adults with learning disabilities. Mencap is the registered provider, while Aldwyck Housing Association owns the building. On the first floor there are five single bedrooms, two communal bathrooms and toilets and a sleep-in room for one member of staff. On the ground floor there are two communal lounges, an office, laundry facility, dining area and kitchen, and a large conservatory. There is a well-maintained garden to the rear of the house. Two adjoining semi-detached houses have been converted into one property, which is not distinguishable from the other domestic households in the residential area of Luton where it is located. Shops and some local services are all within walking distance. Public transport into Luton town centre runs near the home. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 12.00 p.m. It took place over 51/2 hours. The manager was on duty at the time of arrival and updated the inspector on the home since the last inspection. There were five people living at the home. All of them were seen during the afternoon and two showed the inspector their rooms and talked to him about the home. In addition records were examined and two members of staff were spoken to. What the service does well: What has improved since the last inspection? What they could do better:
There was ongoing work to introduce the person centred planning records in ways that would ensure that it was clear where all the up to date information was held so that it could be easily available and all routinely reviewed. The manager was introducing the new recording systems as quickly as possible. While the inspector was satisfied that staff worked well with those living at the home who could sometimes be violent or destructive, he was concerned that they had no training in physical intervention should this become necessary. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 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. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 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 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 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) 2 The needs and aspirations of those considering moving to the home were appropriately assessed so that they only moved to the home if it was known that these could be met. EVIDENCE: There had only been one person who had recently moved to the home. The records relating to the move showed that the procedures for ensuring a full assessment, which were contained in the statement of purpose, were followed. There was a detailed assessment of the person provided by the nursing service on the file and records of the visits the person made to the home prior to moving in. The records kept of the home visits made as part of the assessment process were seen as good practice. Talking to the person and staff provided evidence that the assessment that the person’s needs could be met had been correct. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 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 and 9 There were effective arrangements for identifying the needs and aspirations of those living at the home so that these would be met in ways that allowed them to live as independently and fully as possible. EVIDENCE: There was comprehensive and up to date assessment and planning information on the personal files of those living at the home. This included risk assessments that reflected the need of all those living at the home for support in all their activities. The progress that was being made in introducing person centred planning was very impressive and provided evidence of the involvement of those living at the home in the process of ongoing assessment and planning. This included identifying clear objectives. In particular the use of photography to provide a record of peoples’ lives and help in communication and creating choices was seen as very good practice. There were arrangements in place to ensure that those living at the home were involved in the decisions associated with the home’s group living environment. There was ongoing work to ensure that the information required on a day-to-day basis for staff was easily accessible. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 10 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14, 15, 16 and 17 Those living at the home were provided with the support they needed so that they were able to maintain appropriate and fulfilling life styles in and outside the home. EVIDENCE: There was evidence, including good planning records, that all those living at the home were being supported to be involved in a wide range of activities. These provided the opportunity for individual development, and included attending day centres and college. There were leisure activities including holidays. They all had regular contact with the local community. All but one of those living at the home had contact with relatives. This was supported by staff, including staff taking people to visit their relatives. Where necessary advocates had been involved and now were invited to some of the service users’ meetings. The statement of purpose made clear the intention to operate the home in a way that created a group living situation. This was observed to be the case with those living at the home all sharing in daily domestic activities supported
75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 11 by staff. It was seen that this helped those living there to maintain as much independence as possible and develop independent living skills. There were arrangements for involving those living at the home in decisions relating to their daily lives, including meals. In particular there were service users’ meetings that were seen from the minutes to appropriately support them to be involved in making decisions relating to their day to day lives. There were appropriate arrangements for meals, with staff supporting those living at the home to eat in a healthy way. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 12 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 and 20 The staff were providing appropriate support to those living at the home to ensure that they maintained as much independence and good health as possible. EVIDENCE: The assessment and planning information seen on the personal files provided detailed and up to date information relating to both the care and health needs of those living at the home. The updating was based on regular input from a range of medical professionals. This included working closely with the Outreach Team to support those who needed help to manage inappropriate behaviour and to ensure there were behaviour management programmes in place to complement risk assessments. There were appropriate arrangements for managing medication, including excellent guidance notes relating to the medication that each person living at the home was prescribed. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 13 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 and 23 There were good arrangements for dealing with the concerns and complaints of those living at the home and to ensure that they were protected so that they would feel they were listened to and safe. EVIDENCE: There was a very good leaflet for those living at the home that made it clear how concerns and complaints would be dealt with in the context of the home or taken, if necessary, beyond the home. The only recent complaint had been from a member of the public and this had been dealt with appropriately. Although not presented as a complaint it became apparent talking to a service user that she would prefer to be able to have a bath rather than a shower but that this was not possible because of physical disability which would require a special bath or a hoist. The manager and staff were aware of the situation and exploring the possibilities for enabling her to bathe have a bath. Appropriate procedures were in place to ensure that incidents of abuse would be dealt with effectively and staff confirmed that they were aware of the procedures that would be followed. Staff confirmed that they had training in working with people whose behaviour could be aggressive, although this did not include training in physical intervention. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 14 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) NONE EVIDENCE: 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 15 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) NONE EVIDENCE: 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 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 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) NONE EVIDENCE: 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 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 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 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 x x x x x x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
75 - 77 Wickstead Avenue Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 18 NO 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 Regulation Requirement Timescale for action 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 23 Good Practice Recommendations All the risk assessments relating to those living at the home who need support because of possible agressive or destructive behaviour should be reviewed to determine if staff working with them need training in physical intervention and at what level. The assessment should involve the Outreach team as they advise staff on dealing with emergencies. 2. 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Clifton House Goldington Road Bedford MK40 3NF 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 75 - 77 Wickstead Avenue I51 s14986 Wickstead Ave v242389 080805 stage 4.doc Version 1.40 Page 20 - 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!
