Inspection on 22/12/05 for 77-79 Bath Road

This inspection was carried out on 22nd December 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

77-79 Bath Road 06/02/07

77-79 Bath Road 09/08/05

77-79 Bath Road 20/01/05

77-79 Bath Road 06/09/04

Similar services:

Trevaylor Manor

Stallcombe House

Stroud Lodge

The Woodmill

Woodland Vale

Bolealler House

Claremont Nursing Home

Althea Park House

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

CARE HOME ADULTS 18-65 Bath Road (77/79) 77/79 Bath Road Old Town Swindon Wiltshire SN1 4HB Lead Inspector Alyson Fairweather Unannounced Inspection 22nd December 2005 11:00 Bath Road (77/79) DS0000003204.V266779.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 Bath Road (77/79) DS0000003204.V266779.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. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bath Road (77/79) Address 77/79 Bath Road Old Town Swindon Wiltshire SN1 4HB 01793 538074 01793 538074 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) Rethink Mrs Carole Leslie Laurelli Care Home 10 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (10) of places Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 9th August 2005 Brief Description of the Service: 77/79 Bath Road is a care home offering accommodation and personal care for up to ten people who have a mental health need. The home is run by Rethink and the property is owned by Bromford and Carinthia Housing Association. It is located in Old Town, Swindon, and is on a bus route within easy access of shops and other amenities. The service opened in 1994, and consists of two detached houses which have been converted in to one property with accommodation over three floors. It is an attractive home, with two lounges, a dining room and a large kitchen. It is light and airy, with comfortable furnishings, and all residents have single bedrooms. There are large mature gardens at the rear of both houses and some parking at the front. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in December. Four residents, the manager and care staff on duty were spoken to. The inspector walked round the premises and examined several records, including medication records, risk assessments and staff training files, as well as attending the staff handover meeting. What the service does well: What has improved since the last inspection? What they could do better: The guidelines for the use of PRN Diazepam should clearly indicate the reasons and circumstances for use. Having this procedure in place will help to make sure that residents are not at risk of over-using their PRN medication. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 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. Bath Road (77/79) DS0000003204.V266779.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 Bath Road (77/79) DS0000003204.V266779.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): 2 Prospective service users have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. EVIDENCE: There is a well established process for the assessment of prospective residents. People are referred to Bath Road through Swindon Borough Council’s Mental Health Accommodation Panel. This referral includes a detailed application form, risk assessments where present and details of the current CPA. During this time residents are invited to visit the house for meals and overnight stays in order to meet the other residents and staff. They can then decide if they wish to move in or not. These visits also allow staff to further assess the needs and goals of the resident, and to assess whether the home might be able to help with these. There had been no new admissions recently because of staff vacancies. Bath Road (77/79) DS0000003204.V266779.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): 7 and 9 Residents make their own decisions about their lives with assistance where needed. They are supported and encouraged to risks as part of their independent lifestyle. EVIDENCE: Residents said that they were supported by staff to make their own decisions, and most people manage their own finances, with some having independent bank accounts and pin numbers. One has an independent appointee and one has support from staff. There are regular residents’ meetings and part of the meeting involves choosing the meals for the following week and also discussing any outings they want to go on. No resident has an advocate, but the complaints leaflet explains that the local Mind group will help them if needed. Residents are supported to take risks where appropriate, and staff work hard at trying to make sure that they are aware of any potential risks. Risk assessments had been done for each resident and these included things such as travelling and smoking safely, with ways of minimising these risks Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 10 identified. The system used by the home had recently been changed, making it easier for staff and residents to read and understand the risk assessments. Bath Road (77/79) DS0000003204.V266779.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): 16 and 17 Residents’ rights are respected and responsibilities recognised in their daily lives. They are offered a healthy diet, with their preferences taken into account. EVIDENCE: Residents can choose when to be alone or in company, and when not to join in an activity. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door before entering. Daily routines are flexible, with people choosing what they want to do and when. Residents have unrestricted access to the home and grounds, and can come and go as they please. There is an expectation that people will help to keep their own rooms tidy although staff support is on offer when ill health prevents this. Mealtimes are flexible to fit in with the daily routines of residents, and a satisfactory and varied menu is in operation, which is compiled on a weekly basis after consultation. Three meals are provided each day, with a choice at breakfast time and lunch, and a cooked meal at tea time. Special diets for Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 12 people with diabetes are provided, as are diet menus where needed and vegetarian options. Drinks and snacks are readily available for service users to make themselves. The dining room is a large, airy room, and residents are encouraged to use it, although people can eat in their bedroom if they wish. Bath Road (77/79) DS0000003204.V266779.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): 20 The home’s medication policies and procedures ensure that service users are safe when their medication needs are being met. EVIDENCE: The home’s medication storage and recording systems were in good order. All staff receive full induction training regarding medication administration, and policies and procedures were current and up to date. A check was done on some of the medication in the storage cupboard and this was found to be all correct. PRN medication is now linked to all residents’ crisis self management plans. One resident was seen to be having PRN Diazepam, and this had been prescribed by a physician for a specific reason. However, the resident was requesting it at other times, and staff were unable to refuse, as there was no specific guideline in place for when the medication should be given. It has been recommended that clearer guidelines are introduced. No resident requires personal care at the moment, although this would be provided as a temporary short term intervention if needed. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents’ views are listened to and acted on. EVIDENCE: The home has a procedure which outlines the steps to take if there are any complaints, and all residents have a copy of this in their room. They are also aware of how to contact the Commission for Social Care Inspection (CSCI). A complaints book is kept in the office, and any complaint would be recorded there. No complaints have been received either by the home or to CSCI. All residents are encouraged to air their views, and both care staff and the manager are keen to hear any suggestion from residents about how the service could be improved. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Residents live in a homely and comfortably furnished environment, although there were two areas in need of attention. The home is clean and hygienic. EVIDENCE: Bath Road is an attractive home, with large airy rooms and comfortable furnishings. There are large mature gardens at the rear of both houses which residents have enjoyed using over the summer. Residents’ bedrooms were homely and each contained individual personal items. The home had been beautifully decorated for Christmas. Since the last inspection, several areas have been decorated, including the ceilings which had been damaged. As some rooms were vacant, the manager and staff had taken the opportunity to decorate these, and to have new carpet laid. One bathroom also had new flooring. One resident had moved into a larger room and was keen to show the inspector how it had been decorated, and how he had arranged his things. The stair carpet had also been replaced. Until recently, it has been part of the care staff duties to clean the house. However, a part-time cleaner has been employed, and is due to start work soon. This will free up care staff time to spend on a one to one basis with residents. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 16 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, 34 and 35 Residents are supported and protected by the home’s recruitment policies and their needs met by appropriately trained and qualified staff. EVIDENCE: One staff member is currently doing his Certificate in Community Mental Health, and another three are due to start. The deputy manager has an NVQ Level 4 in Management and a City & Guilds Certificate in Advanced Management for Care. Some qualified staff members have recently left the home, and new staff have been recruited. Staff training files examined showed that training had been given in Basic First Aid, Basic Mental Health Awareness, Food Hygiene, Race Equality and Psychosocial Approaches. All staff have had medication administration training. Staff recruitment is assisted by Rethink’s human resources department. All potential staff members meet with residents informally and it is hoped that some will become more involved in the formal interview. Staff are interviewed using a standardised set of questions and a scoring system. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Two written references are also required. There is a six month probationary period, and the manager meets with staff half way through this period to review progress. All the staff files looked at contained the appropriate documentation. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 17 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 and 42 Residents benefit from a well run home. The health, safety and welfare of the people using the service are promoted and protected. EVIDENCE: The manager has many years experience of working with people with mental health needs, and has a Professional Certificate in Management and an NVQ Level 5 in Operational Management. All staff have had food hygiene training and food temperatures are recorded on a daily basis. The fire bell is tested weekly and the emergency lights and fire fighting equipment are tested monthly. The home has two designated fire wardens, and fire drills are conducted on a regular basis. Some residents do not like to evacuate the building, and prefer to ignore fire drills. Staff always record who has attended the drill and then talk to the residents who do not attend about the potential danger if there was a fire in the house. A recent Health & Safety audit conducted by Rethink suggested that they could perhaps view a DVD of what to do in the event of fire, and the manager is to investigate this possibility. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 18 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 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bath Road (77/79) Score N/A X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000003204.V266779.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? NO 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. 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 YA20 Good Practice Recommendations The guidelines for the use of PRN Diazepam should clearly indicate the reasons and circumstances for use. Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Bath Road (77/79) DS0000003204.V266779.R01.S.doc Version 5.0 Page 21 - 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. 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