CARE HOME ADULTS 18-65
7a Finborough Road 7a Finborough Road Short Break Service Stowmarket Suffolk IP14 1PN Lead Inspector
Helen Fontaine Unannounced Inspection 1st February 2006 04:00 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service 7a Finborough Road Address 7a Finborough Road Short Break Service Stowmarket Suffolk IP14 1PN 01449 626205 01449 626205 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) Suffolk County Council Mr David James Gilbert Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection Brief Description of the Service: Opened in 1995 as a short break facility, Finborough Road is registered as a care home for 4 adults with learning disabilities. Suffolk Social Services are the registered provider. Service users are expected to continue with their day care services during their stay at Finborough Road. The local social care services day centre closes for ten days per year and on these dates Finborough Road offers day care for service users during the day although no over night respite services are offered on these days. The home is situated close to Stowmarket town centre within a small cul-desac of buildings. There is a large driveway with a parking area shared by other buildings. The house has four individual bedrooms, two on the ground floor and two on the first floor. There is a spacious kitchen/dining room, which opens onto a patio area. The living room leads into a staff sleep in room which doubles as a duty office. A shower room, suitable for wheelchair users, separate toilet and laundry area are also on the ground floor. A wide staircase leads to the bedrooms upstairs, bathroom, toilet, storeroom and manager’s office. There is another patio area behind the laundry, which overlooks a pond. Towards the front of the building there are views towards the church. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection of 7a Finborough Road took place over four hours and was the second statutory inspection visit in the inspection programme for 2005/6. Over the course of the two visits, all core standards have now been assessed. Four requirements and one recommendation were set at the previous inspection and the home has complied with all but one. This requirement the timescale has not yet been reached and this has been restated with the original timescale. No further requirements and only one recommendation was identified at this inspection. The manager and the deputy manager were present during the inspection and their support was very much appreciated. Four residents were present during the inspection and participated at times as much as they were able. What the service does well:
The home offers service users respite and this can be for a single night or over a longer period. Each resident has a choice of room if it is possible, disability allowing and they bring with them items that are important to them. The home has to balance carefully the wishes of the service user and that of the carer/family member but no resident stays at the home unless they want to. The home was a very relaxed and happy place where residents were freely accessing all areas of the home. The residents were asked if they minded the inspector looking at their rooms and all of them were happy to do this. Despite the home being a respite care unit, the home did have on the resident’s care plan aims and goals. Some of these might be quite simple like unpacking or packing their own bag, or making their own sandwiches for the next day to deciding and organising what they wanted to eat. Meal times are especially good, the home has a good stock of different foods and the residents are free to choose what ever they want. If the resident chooses something that the home does not have, there is a supermarket right behind the home and the staff and resident go and buy what they need. The home have to balance the different needs of the residents, some may have had a full meal at midday and not want a cooked meal in the evening and some may have had sandwiches and require a cooked tea. Staff training is an area the home has exceeded the minimum standard. The homes manager has National Vocational Qualification (NVQ) level four and so does the deputy, more than 50 of the staff have National Vocational Qualification (NVQ) level three. The other area the home has been assessed as exceeding The National Minimum Standard is around the quality assurance checks. The home has the
7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 6 difficulty of a large number of residents using the home during a year. The home has addressed this issue, by each resident having a questionnaire in their room. The manager informed the inspector that staff assists the residents to complete this form on the last night of their stay. The home also has regular evening meetings for the carers/family as well as a representative of the residents. This forum raises money for the home and the residents, as well as keeping them informed of events happening at the home. What has improved since the last inspection? 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. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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): 5 The residents can expect to receive an up to date contract once the new rates have been published. EVIDENCE: The home has a requirement from the last inspection about the terms and conditions of accommodation. However the home cannot add to the contract the rate of the fees, until the Local Authority have published their new fees for the current year. The manager indicated that they should have the information by May 2006 and will then make sure that all the contracts reflect this. The requirement for the timescale for action is documented as 7th November 2007 and will be changed in this report to 7th November 2006. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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 can expect to make decisions about their lives and receive support to take risks as part of an independent lifestyle. EVIDENCE: The residents’ care plans include the aims and goals that have been agreed they wish to achieve. In addition to the documentation on their care plan there is also a room book and one resident’s room book was looked at during the inspection. The resident’s goals included stripping the bed and remaking it with assistance, put their washing in the laundry room with prompting as well as being helped to unpack and pack. Another goal was to make their own sandwiches and independently shower and wash their own hair. Each resident has at the end of their stay, a personal feedback form to take home with them. This form has the name of the resident and the key worker, the duration of the stay and number of nights at the home. The form is completed with the activities they took part in and one form looked at documented that the resident watched television in their own room and attended the Gateway Club. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 10 During the inspection the residents were asked if they would show the inspector their rooms. Residents said that they liked their rooms and that they were able to choose which room they had. The inspector joined staff and a resident for their tea and it was observed that residents were given choices about what they had. The manager indicated that the residents could access snacks and drinks at any time during their stay. At the previous inspection a requirement was made regarding risk assessments. The risk assessments were looked at and all of them had been reviewed, identifying the changes of the resident. However there were a few out of date risk assessments that were no longer applicable and a recommendation that they remove from the folder any inappropriate risk assessment has been made. One of the residents has some behaviour that could cause the other residents distress. The risk assessment around their behaviours was looked at and the manager indicated that this resident is socializing more appropriately. The risk assessment for this resident covered areas of risk about entering other peoples bedrooms/private areas uninvited, the consequence of this and how the risk can be reduced. The risk assessment documents that staff should supervise this resident. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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 can expect to have their rights respected and be offered a choice of meals at times of their choice. EVIDENCE: During the tour of the home, there were a number of framed pictures on the wall of the home. The manager said that these pictures were all artwork that the residents had done themselves. The artwork is photographed, enlarged and framed and these pictures are used as part of a calendar that is sold to raise funds for the home. The manager said that the residents are very excited when their piece of artwork is chosen and enjoyed seeing their pictures on the calendar. The inspector talked to some of the residents and all of them said how much they liked coming to the home. The manager indicated that every effort is made to establish that the resident chooses to come to the home and it is not just the wish of the carer/family. This is a difficult dilemma for the home as the home is a respite unit for the carers/family, however the manager said that very few refuse and those that have do express their opinions clearly.
7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 12 The home has been assessed as exceeding The National Minimum Standard for meals and residents being offered a healthy diet. The home does not know before the residents arrive whether they are going to want a meal or just a snack and it is the choice of the resident what it is they want to eat. The home keeps a choice of foods at the home and the manager said that if the resident chooses something that they have not got, they have a supermarket next door. A record is maintained of what the residents have had to eat during their stay to make sure any special requests or needs are met. The inspector joined the manager, deputy manager and a resident for their evening meal. The resident was enjoying a sweet that the staff had made, which consisted of yoghurt, fruit and topped with a small amount of cream. All the home’s meals are cooked in a domestic type kitchen and residents are encouraged to take part or even do their own. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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 Residents can be sure that they are protected by the home’s policies and practices around the issue of medication. EVIDENCE: The home has two residents that can self medicate and each room has a cupboard with a lockable drawer where the residents can keep their medication or valuables. The Medical Administration Record (MAR) sheet was looked at during the inspection and each sheet was found to be initialled appropriately. As the home is a respite care unit, the residents bring their medication with them and this was seen to be carefully documented on their care plan and room book. The home has the Local Authority’s policies and procedures and the manager indicated that these are all updated regularly. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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): 23 The residents can expect to be protected by the home’s policies and practices. EVIDENCE: At the last inspection the home received a requirement relating to staff training in the area of Adult Abuse. The manager produced the documented evidence that all the staff have now attended the Local Authority’s Adult Protection course. The manager said that the home are currently planning a training exercise, where staff will be given an Adult Abuse scenario whilst on duty and be asked to deal with it. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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): These standards were not inspected on this visit. However evidence from the last inspection was that, service users can expect to live in a safe, wellmaintained and welcoming environment, which provides a good range of communal and persona accommodation. Service users can expect that the service will be kept clean and hygienic and have access to aids and equipment they need to promote maximum comfort and independence. EVIDENCE: This area will be examined in more detail in future inspections. These standards have been previously assessed as well met, and during the inspection no concerns were raised or noted. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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): 34 and 35 Residents can expect to be supported by staff that are well trained and be protected by the home’s recruitment polices and practices. EVIDENCE: At the last inspection a requirement was made about the clerical support needing to have a Criminal Record Bureau (CRB) check. Records checked during this inspection, evidenced that all the staff working at the home in whatever capacity do have a current Criminal Record Bureau (CRB) check. The home was assessed as exceeding The National Minimum Standard (NMS) around staff training. The home had documented an extensive staff-training programme. The manager and the deputy both had the National Vocational Qualification (NVQ) Level four. The staff team had NVQ Level three. This exceeds the NMS, which states that 50 of the staff should have the NVQ level two. Staff also had certificates for manual handling, Adult Abuse training, basic food hygiene, challenging behaviour, epilepsy, awareness of complaints and compliments, Unisafe and medication. The staff had also undertaken the Local Authority’s in house training in autism, principals and philosophy of social care and valuing people. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 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): 39 and 42 Residents can be assured that their views underpin the development of the home. The health and safety of the residents are promoted and protected. EVIDENCE: The home gives each resident a questionnaire that gives them the opportunity to feed back their views of the home. The manager indicated that the staff support the residents completing the questionnaire at the end of their stay. This questionnaire is in pictorial format that allows the resident to understand what is being asked. The questionnaire says, “When you stay at 7a do you feel, happy, relaxed, safe, comfy, cared for, upset, angry”. Another question did you do things you liked and then covered areas like go shopping to town, mixing with others and did you choose your food. The questionnaire also asks if you have enough to drink and was the food tasty, were you spoken to nicely or treated nicely. All the questionnaires that the inspector looked at were all ticked positively and no negative feedback was found. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 18 Regular meetings for carers/families with a representative of the residents are held. A meeting was taking place the evening of the inspection and towards the end of the inspection the deputy manager left to attend this meeting. The meeting not only keeps the carers/family informed, but it has also raised money for the home. Records around health and safety were looked at and these were extensive and well documented. Each resident had a manual handling risk assessment and this included a risk assessment when there is not a risk. The risk assessment around manual handling where documented with the identified risk and were some eight pages long. The home had all the servicing records for their equipment, which included hoists and the homes domestic equipment. The records for the fire risks and fire protection service certificates were also available. The inspector tested the water temperatures and found that the sinks in the upstairs bathrooms were both at 42°C. The home had been recently putting a great deal of effort into the documentation around Health and Safety and were able to provide for the inspector all the necessary documentation to evidence that the home met this standard. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 19 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 Standard No Score 1 X 2 X 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X 3 X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 3 X X X 4 X X 3 X 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 20 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. 1. Standard YA5 Regulation 5(b) Timescale for action The terms and conditions in 07/11/06 respect of accommodation to be provided to the service user must be updated to include the current fee and method of payment. Requirement 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 YA9 Good Practice Recommendations The risk assessments kept are those that are valid and up to date and all risk assessments that are not longer valid are moved from the folder. 7a Finborough Road DS0000036836.V281644.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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