Inspection on 15/11/05 for 76-78 Hampstead Road

This inspection was carried out on 15th November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

76-78 Hampstead Road 26/11/08

76-78 Hampstead Road 04/06/08

76-78 Hampstead Road 05/06/07

76-78 Hampstead Road 06/07/06

76-78 Hampstead Road 13/07/05

76-78 Hampstead Road 13/01/05

76-78 Hampstead Road 18/06/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 76-78 Hampstead Road Brislington Bristol BS4 3HN Lead Inspector Sandra Jones 15 & 29 th th Unannounced Inspection November 2005 09:30 76-78 Hampstead Road DS0000026628.V263761.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 76-78 Hampstead Road DS0000026628.V263761.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. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 76-78 Hampstead Road Address Brislington Bristol BS4 3HN 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) 0117 9728513 0117 9699000 The Brandon Trust Mr Julian Cyril Thomas Morse Care Home 12 Category(ies) of Learning disability (12), Physical disability (12) registration, with number of places 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 12 persons aged 18 - 65 receiving personal care. 13th July 2005 Date of last inspection Brief Description of the Service: Hampstead Rd is operated by the Brandon Trust and managed by Julian Morse. It is a registered care home for twelve younger adults with learning and/or physical disabilities. The property was purpose built to accommodate people with physical impairments. As the property is purpose built to accommodate people with physical impairments, there is level access and wide corridors. It blends well with its local residential environment and close to shops, park and bus routes. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over two days in November 2005. The residents accommodated have profound learning disabilities and for this reason the interaction between staff and residents was observed. Members of staff commented on the conduct of the home. Records examined were used to confirm the standards of care at the home and a tour of the premises took place to endorse the findings of this inspection. The CSCI is provided with copies of the monthly visits undertaken at the home, which are conducted by a representative of the Trust. What the service does well: What has improved since the last inspection? The manager and members of staff have assessed the technology available to enable residents to make choices and develop independence. One resident has been provided with equipment that enhances their ability to make choices. Aids and adaptations are primary for residents that have physical impairments. Wheelchairs that support residents with complex physical needs have been provided. Since the last inspection a link between monthly monitoring reviews, daily reports and care plans has been developed. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 6 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. 76-78 Hampstead Road DS0000026628.V263761.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 76-78 Hampstead Road DS0000026628.V263761.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): These standards were not examined at this inspection. Requirements about information to be included within the Statement of Purpose were actioned by the manager. EVIDENCE: 76-78 Hampstead Road DS0000026628.V263761.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 To ensure legislation is met and to raise awareness about the person as an individual with a past, case records must include background histories and a current photograph. A person centred approach to meeting residents is in place, which is respectful to the individual. Risk assessments for using monitors in residents’ bedrooms must be completed and must evidence that the actions are consistent with the level of risk. EVIDENCE: The records of four residents were examined during this inspection. Background histories were incorporated into two files and a current photograph was included into one file. Case records must be kept in order and up to date. The assessed needs are listed and the routines for meeting the needs are specified. Information that respects the persons is combined within the action plans. For example, knocking on the door although the person will not respond 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 10 and leaving someone unsupervised in the toilet. Communications needs are described within the care plans. Signs, symbols and gestures used are explained along with their meaning and the actions to be taken by the staff. There is documentation kept in the case files from outside professionals and therapists. Evidencing that residents have access to GP’s, healthcare professionals. The progress of the care plans are monitored monthly by the keyworker. Any change to each element of the needs is recorded along with a description of leisure time activities. Copies of the reviews are sent to relatives and the manager request feedback. Since the last inspection there is a better link between the monthly reviews and the care plan. During the inspection, it was noted that monitors are used in residents bedrooms. It was understood that these are used at night to alert staff if a resident requires medical attention. For example, epilepsy. However, risk assessments that confirm that this level of intrusion is relevant to the level of risk to the person. Risk assessments for using monitors in residents’ bedrooms must be completed and must evidence that the actions are consistent with the level of risk. 76-78 Hampstead Road DS0000026628.V263761.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): 15 &17 Members of staff support residents to maintain links with family and friends. Menus in place support the variety and nutritious meals served to the residents. EVIDENCE: Incorporated within case records are the names of the people that are important in that person’s life. Making and Maintaining Relationships is an element of the (ELP) Essential Lifestyle Planning format. Meeting others, facilitating access to move around the home and group activities are explored to assist residents with developing social contact. Members of staff at the home send copies of the review minutes to relatives and the within the format their feedback is sought. Care notes describe the actions taken by staff to enable residents to maintain links and relationships for example, taking residents to visit friends and family. The visitors book evidenced that residents receive visitors at the home. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 12 Menus are prepared by the staff and include three meals and snacks each day. For breakfast there is cereals, fruit and refreshments, with sandwiches for residents that have a midmorning snack. Members of staff prepare a light lunch followed by an afternoon snack and a cooked meal in the evenings. At night before residents retire snacks and drinks are served. It was understood from a member of staff that menus are changed each Tuesday and groceries purchases reflect the meals to be prepared. Additional groceries are purchased on Saturdays. A good range of frozen, canned and fresh provision was found and whenever alternatives are served, the menus are altered. A record of fridge and freezer temperatures is maintained. However, a record of cooked meats is not currently kept. A record of the temperature of the cooked meat must be maintained. Members of staff were observed assisting residents with their meals. Members of staff engaged with each person they were assisting and a variety of approaches were used to ensure residents ate their meals. 76-78 Hampstead Road DS0000026628.V263761.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, 19 & 20 Members of staff assist residents with personal care and the records guide the staff to complete tasks in a respectful and sensitive manner. Residents health is monitored and where necessary referred to the GP for further investigation. Safe practices are in place for the administration of prescribed medications. EVIDENCE: Residents accommodated require assistance with personal care. ELP’s details the individuals routine for personal hygiene, getting up, having a bath/shower and appearance. Within the case records, the equipment necessary for safe lifting is detailed. Assisted baths, hoists, manual handling belts and sliding sheets are used at the home. Members of staff attend manual handling update training to ensure safe lifting practices exits at the home. Documentation held within case records indicated that additional specialist support is provided by Speech and language therapist and physiotherapists. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 14 Keyworkers take residents on shopping trips and on their perception of the person purchase age appropriate clothing. Records in place evidenced that staff monitor residents health care needs and where necessary refer to the GP for further investigation. It is the responsibility of the member of staff accompanying the resident to inform the staff team. Each time the GP is contacted, a standard format is use to record the reasons for the visit, the diagnosis and the advise given. Residents access NHS facilities. The dentist visits the home six monthly and the optician annually and the residents visit the chiropodists at the health centre. Medications are administered from a monitored dosage system by the staff. The records of administration indicate that staff that administer and witness sign the records once the medications are administered. When required medications are administered from standard bottles and recorded within the administration sheets. A running balance is maintained and accurate recording was found for medications checked. There is a “returns” book provided by the pharmacist and used to record medications no longer required at the home. To indicate receipt of the medication for disposal the record is countersigned by the pharmacist. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 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 the following standard(s): 22 & 23 Members of staff are clear on the procedures that safeguard residents from abuse. Procedures are in place for raising concerns on behalf of the residents. EVIDENCE: There were no complaints received at the home for investigation since the last inspection. Members of staff comments indicated that a part of the keyworker role was to raise concerns on behalf of their key resident. Residents communication needs are described within case records along with the interpretation of the gestures, vocal sounds and signs. Since the last inspection members of staff attended the POVA training provided by an external training provider and organised by the Trust. Members of staff giving feedback confirmed the procedure for alerting poor practices that is witnessed. The staff described examples of poor practice and the process that would be followed was clearly expressed. While the manager has completed the POVA alerters’ course, consideration should be given to attending the POVA workshop specific for managers and service providers. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 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 the following standard(s): 24 To provide a safe comfortable environment for residents, repairs and replacements must take place. EVIDENCE: Hampstead Road is purpose built to accommodate people with physical and sensory impairments that have learning disabilities. The accommodation is arranged into two separate dwellings, which is linked by shared space and office upstairs. There are six single rooms, lounge and kitchen/dinner in each house. Other shared space consists of a Snoezelen and activity room. It is located close to shops, places of worship, amenities and bus routes. The staff accompany residents and the home’s vehicle is used to access community facilities. A tour of the premises was conducted and a number of repairs were noted. The arm of the dining room chair in house 1 is broken are requires repair, the hoist in house 1 cannot be used because it requires repair, a resident’s bedroom carpet has iron marks and must be replaced. In the kitchen, tiles were missing and required replacing. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 17 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 18 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): 36 The support provided to staff through supervision ensures that they carry out their job in a way, which benefits residents. EVIDENCE: Trust staff visit the home monthly and report on the conduct of the home. Copies of the report under Regulation 26 are sent to the CSCI. Annual appraisals take place with the manager. Individual supervision takes place monthly with line managers. Training issues, residents staffing issues and expectations of the role are discussed during the supervision. Members of staff consulted reported that supervision is regular and scheduled to avoid cancellation of the meetings. 76-78 Hampstead Road DS0000026628.V263761.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): 38 & 41 The systems in place for continuity of care enhance a positive and inclusive culture. Records examined are up to date and in order which ensure residents interests are safeguarded. EVIDENCE: The staff’s opinion on the conducted of the home was sought during the inspection. It was reported that systems are in place to maintain the standards of care at the home. Staff meetings, supervisions and handovers were described as the systems that provide continuity of care. Induction for new employees, LADF training, other training and vocational qualifications take place at the home to ensure residents specific needs are met by competent staff. In terms of meeting the individuals needs, the keyworker system was described as the process that ensure staff’s have specialised knowledge of the individual. 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 20 The rota in place indicated that three staff with a senior on each shift are rostered in each house. The manager undertakes a combination of supernumerary and “hands-on” roles during the week. Ancillary staff are employed to maintain the building clean. Two staff are awake in each house at night. Where activities are organised additional staff are rostered, during the inspection residents were preparing to attend an organised event outside the home and additional staff were on duty. Facilities for the safekeeping of cash and valuables exist at the home. The records of cash were checked against the cash held in safekeeping, which are signed by two people. Receipts are appended onto the record to further evidence the purchases made on behalf of the residents. The records examined are kept in order and up to date. Through Regulation 37’s the manager maintains the CSCI aware of any incidents and occurrences that affect the well being of the residents. The records that relate to fire safety policies, procedures, checks and practices were examined. From the records it is evident that checks and practices take place at the stipulate frequencies. Fire risk assessments are completed to ensure the level of fire occurring at the home is reduced and for the safe evacuation of residents. The fire risk assessment must incorporate an assessment for the staffing levels at night. This will ensure that in the event of a fire at night residents will be safely evacuated. 76-78 Hampstead Road DS0000026628.V263761.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 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x x x 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 76-78 Hampstead Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 3 x DS0000026628.V263761.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 YA24 Regulation 23(2)(b) Requirement Timescale for action 30/03/06 2 YA41 18(1) (a) 3 YA6 13(4) (c) The following repairs/replacements must take place: the broken chair in the dining room, the hoist in house 1, the missing tiles in the kitchen and the carpet with iron marks. The staffing levels at night must 30/01/06 be assessed to ensure members of staff can evacuate the home safely at night in the event of a fire. Risk assessments must be 30/12/05 completed for monitors that are used at night in residents bedrooms 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 YA23 Good Practice Recommendations The manager should consider attending external POVA training for managers and service providers 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG 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 76-78 Hampstead Road DS0000026628.V263761.R01.S.doc Version 5.0 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. 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