Inspection on 09/08/05 for 77-79 Bath Road

This inspection was carried out on 9th August 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 22/12/05

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 9th 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. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 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 Laurelli Care Home 10 Category(ies) of MD Mental Disorder (10) registration, with number of places Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 20th January 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 that 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) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in August. There were several residents at home, five of whom were spoken to. The manager was away, and care staff are to be congratulated for the professional manner in which they conducted the inspection. The inspector walked round the premises and examined several records, including care plans, medication records, and assessment information, as well as attending the staff handover meeting. What the service does well: What has improved since the last inspection? The type of things which residents do in their spare time has improved. People now spend more time outside the home, with staff accompanying them to various events. Some multicultural events have been attended, including a Jamaican music night and the Swindon Mela. Staff are enthusiastic about encouraging healthy living, and will happily go with residents for walks or day trips. More sporty activities have also been started, including table tennis, golf, pitch and putt and badminton. One resident had been to the Speedway racing and was very keen to go back on a regular basis. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.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 Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.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 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. One resident had recently moved in without having visited the home. It was good to note that the home’s manager had sought reassurance from the hospital mental health team that staff could access support from them at short notice if needed. The resident’s named nurse from the hospital had also offered support, and various risk assessments had been obtained. The resident himself said he was happy with the information which he had been given about Bath Road before he moved in. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.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 and 9 Care plans reflect the needs and personal goals of respite guests, which means that staff are able to support them in the way they wish. They are supported to take risks where appropriate, and encouraged to be as independent as possible. EVIDENCE: Each resident has a care plan which is reviewed on a monthly basis by the resident and their key-worker. Care plans focus on individual’s strengths as well as any need or problem, and contain sections on communication abilities, domestic abilities, mental health, physical health and sleep patterns, among others. Residents have the opportunity to record their comments on the reviewed care plan. Each person also has a crisis self-management form on file. This takes the form of an advance directive, which confirms who the resident would like to be notified and what treatment they would like, in the event of them becoming ill or being admitted to hospital. This also applies to PRN medication. Staff spoken to were very sensitive to the needs of residents and the different approaches needed to help build their confidence. Risk assessments had been done for each resident and these included things such as travelling and smoking safely, and ways of minimising risks were Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 10 identified. There was good information recorded about potential risks, although the risk assessment format used was slightly unclear. The current method used means that all risks are rated together, and are scored using a numerical system. There was no obvious record of what the scores meant, and it was not clear how this figure influenced any planned action. The manager has been asked to ensure that each risk identified has a separate risk assessment on file, and it is recommended that the numerical scoring is clarified if its use is to be continued. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.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 and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. EVIDENCE: Residents are encouraged to develop and maintain their independence as much as possible and they can come and go as they wish. Over the summer period, residents had enjoyed activities such as a game of golf, trips to the cinema, a walk in the local gardens, pitch and putt, a Jamaican music night and a trip to the Swindon Mela. Other activities include going to discos, going to a club with Swindon Mind, badminton and horse-riding. Some residents had taken advantage of the good weather and played table tennis in the garden, and another spoke of his enjoyment of going to the speedway racing. Others had recently enjoyed a trip to Avebury. Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time, and can Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 12 entertain and choose to see who they like either in the privacy of their own bedrooms or in the communal areas available. The resident satisfaction questionnaire has been extended to family members in a bid to ensure good relationships between the home and residents families. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.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) 19 and 20 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. The home’s medication policies and procedures ensure that service users are safe when their medication needs are being met. EVIDENCE: All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health resources, which enables an effective response to any crisis periods that may arise. All residents attend mental health reviews on a regular basis, and the care plan may be amended at this time. 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. It was good to note a stock of sun cream for residents, in light of the current hot weather. PRN medication is now linked to residents’ crisis self management plans although there was one instance where this had not been done. If this system is to be continued, then it should be done for all residents. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 standard(s) 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members have received Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 standard(s) 24 and 30 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 was mainly in good order, although there were several parts of the ceiling which needed attention as they had been damaged when some water pipes had burst. One carpet was rather threadbare and could be a source of potential risk for any resident with poor mobility. The manager has been asked to ensure that these areas are attended to. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Residents are supported by an effective staff team. EVIDENCE: Two new members of staff were spoken to and were both enthusiastic about the support they had had from both colleagues and the manager. One said that she felt able to ask questions if there were things she didn’t know and that everyone had been really helpful. A communications book is also used by staff, and this records any incidents and appointments made for residents. This record is the basis for the team handover meeting, and the previous shift leader informs the rest of the team of any events in the home since the previous day. During this meeting, staff were seen to be extremely well informed about the wellbeing of all the residents, and able to discuss any detail. There was a good rapport observed between residents and staff, although difficult issues were able to be tackled. One resident was very concerned about his personal safety if he left the house, and staff were able to talk to him about his current mental state and how this might be affecting his perceptions. Staff had also re-assured him about being able to come home at any time when he was out if he felt unsafe. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 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) 39 Residents know that their views, and those of their families, underpin the monitoring and review of care practice. EVIDENCE: There are various quality assurance methods used in the home, including regular monthly visits to the home by the provider. Comprehensive reports of these visits are sent to the CSCI. A service user survey has been conducted, as well as a formal survey for relatives. The results of these had all been collated and there was evidence that action had been taken to deal with any comments or concerns raised. For example, one resident had requested the delivery of a local daily paper, and this was now in place. Another made the comment that “staff members do well in areas such as asking for our opinions on topics such as how we feel and what we would like to do etc. which is a nice thing to have”. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bath Road (77/79) Score x 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 19 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. 2. Standard 9 24 Regulation 13 (4) (b) 23 (2) (b) Requirement There must be a separate risk assessment in place for each assessed risk. The ceilings which were damaged by water must be repaired. Timescale for action 09/10/05 09/10/05 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. 2. 3. Refer to Standard 9 20 24 Good Practice Recommendations The scoring system used on risk assessments should explain what the number means and how it links to the action plan relating to each risk. All residents should have their PRN medication added to their crisis self management plan. The worn carpet should be replaced. Bath Road (77/79) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 Page 20 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, 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) D51_D01_S3204_BathRoad(7779)_V210363_090805_Stage4.doc Version 1.40 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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