Inspection on 08/08/05 for 8 Blunt Street

This inspection was carried out on 8th 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

8 Blunt Street 01/10/08

8 Blunt Street 09/10/06

8 Blunt Street 05/01/06

8 Blunt Street 14/02/05

8 Blunt Street 02/06/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 8 Blunt Street Stanley Common Ilkeston Derbyshire DE7 6FZ Lead Inspector Tony Barker Unannounced 8 August 2005, 9.35am th 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. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 8 Blunt Street Address Stanley Common Ilkeston Derbyshire DE7 6FZ 0115 9323494 0115 9323494 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) United Response Christine Coates Care Home 3 Category(ies) of LD - 3 Places registration, with number of places 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14/2/2005 Brief Description of the Service: 8 Blunt Street is a semi-detached house in a small village development. Service users are provided with adequate accommodation and single rooms. There is a rear garden. The Home offers personal and social care to people with a severe learning disability with associated conditions that include autism and sensory disability. Activities are planned to meet individual needs. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 4.75 hours and was a routine unannounced inspection. The last inspection took place in February 2005 and was an unannounced inspection. This inspection was the inspector’s first visit to the Home. The Manager was spoken to, records were inspected and there was a tour of the premises. Three service users’ records were examined as part of the case tracking method. Service users’ disabilities were such that they were unable to speak except on a single word level. However, they had varying degrees of non-verbal communication with the inspector. The focus of this inspection was on progress made on the requirements and recommendations made, and those standards not assessed, at the last inspection. What the service does well: What has improved since the last inspection? What they could do better: Written Information about the Home must be updated. A further review of risk assessments must take place. Some Health, Safety and Hygiene issues must be addressed. Updating of the Home’s staff recruitment procedures is also needed. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 5 Full information about the Home was not available in order for prospective service users and their families to make an informed choice about where to live. Current service users were also not benefiting from this information. Service users’ needs were providing an ongoing basis for care provided. EVIDENCE: The Home’s Statement of Purpose had still not been personalised to the Home although it had been updated to include reference to the Commission for Social Care Inspection. The Manager did not have access to the current edition of the National Minimum Standards – therefore, she was not aware of the need for the Statement of Purpose and Service Users’ Guide to address environmental standards. The current record of charges at the Home was made available. There had been no recent admissions to the Home. Service users’ files contained detailed assessments of need and it was noted that these assessments were being kept under review. A written contract between the funding authority and United Response, with regard to one service user, was still not available. An ‘Individual Charter’, between United Response and each service user, was seen but these had still not been fully completed, or updated since December 2002. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 9 Service users’ needs were being fully considered and regularly reviewed. A good range of potential risks had been identified and plans put in place to minimise these. Service users were being supported to take responsible risks. EVIDENCE: The files of each service user were viewed as part of the case tracking process. Each file provided a detailed record and had up-to-date care plan reviews. Person Centred Planning Sheets provided a useful record of each service user’s needs, likes and goals. However, daily and nightly log entries did not reflect the objectives outlined in review meetings. One file showed evidence of an external advocate’s involvement in making decisions over replacement furniture in the service user’s bedroom. The assessment of risk was central to the Home’s care planning. A good range of risk assessments and risk management records were seen and the range had been improved since the last inspection. There was a rug on the floor of two service users’ bedrooms which, while adding a homely touch, could prove to be trip hazards – especially for the service user with poor eyesight. There were no risk assessments for these rugs. The Manager described a pro-active approach being taken by the staff group with regard to taking considered risks. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 10 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.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) 11,12,13 & 17 Service users were benefiting from opportunities to develop skills, take part in stimulating activities and participate in the community. They were offered a healthy diet and enjoyed mealtimes. EVIDENCE: From discussion with the Manager and from observations it was clear that service users were being given frequent opportunities to develop their social, emotional and communication skills. An example of the latter would be the use of photographs and pictorial symbols around the building. One service user was attending college for four days a week undertaking a life skills course. He was able to communicate his pleasure at carrying out this activity. Written Support Plans were displayed on the hall wall, reflecting a range of activities in which service users participate in the community. Some of these were specialist and some integrated. Two service users were provided with one-to-one home-based day services. The Manager spoke of a new United Response day service provision being planned that would widen the activities and social networks for these two service users. Photographs of service users 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 12 and staff on trips and outings were kept in service users’ files. The Manager felt this motivated staff to communicate with the service users about these events and elicit their views. The sample menu supplied with the pre-inspection questionnaire indicated that a nutritious and balanced diet was being provided. Regular takeaway meals were an established feature. The three service users were observed, during this inspection, eating their lunch together in the dining room in a quiet and relaxed way. The kitchen larder was well stocked and appropriate food hygiene practices were noted around the kitchen. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.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) 20 Service users were being protected by the Home’s procedures for dealing with medicines. EVIDENCE: Service users were receiving regular sight checks. Other aspects of service users’ healthcare, including the availability of annual health checks from the local primary healthcare services, as recommended at the last inspection, were not assessed. Medication was being stored securely. Medication records were read and found to be satisfactory. A monitored dosage system was in use. The quality of staff training in the use of medicines, and in certain practices, had improved since the last inspection. It was noted that the local pharmacist is now providing annual staff training and undertakes a quality audit bi-monthly. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.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) Service users were likely to benefit from the Home’s complaints procedure but not all efforts had been made to explain its operation to them. Service users were being protected from abuse and self-harm. EVIDENCE: The Home’s complaints procedure was displayed in the ground floor office. This was not in an appropriate format for services users to read or be guided through. There was a discussion with the Manager about ways of achieving a balance between a domestic environment and the benefits to service users of increased awareness of their rights. The Manager spoke of still awaiting an advocate for one service user – someone who would help him meet his potential, particularly given he had no family support, she said. The Manager was understandably pleased with the reduction in challenging behaviour of one service user over the last eight months. Body maps were recorded whenever marks were noticed on service users. One seen was dated but not signed. Other aspects of the Home’s system for managing concerns, complaints and adult protection were not assessed. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.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 & 26 The Home fell somewhat short of providing a homely environment for service users. The safety of service users was being somewhat compromised by an inadequate frequency of fire training for staff. EVIDENCE: All the previous requirements and recommendations relating to maintenance and environmental improvements had been met – although the Home was still in need of a more homely appearance. The Manager said that the Home was moving towards providing furniture and furnishings of a more domestic appearance. There was no toilet paper or towel in the staff toilet. The Home was providing annual fire training sessions to staff – the last one being on 27 September 2004. There was discussion with the Manager regarding the benefits of making one service user’s bedroom walls less bare through the use of framed pictures. There were personalised pictures on the outside of two bedroom doors. All bedrooms had lockable doors although service users do not hold there own key. There was no lockable space in service users’ bedrooms. The Manager accepted that lockable space would benefit one service user as would holding his own door lock key. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 16 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 17 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 & 34 Service users were being supported by an effective staff team. However, the Home was not fully protecting service users by means of staff recruitment practices. EVIDENCE: 25 of the staff had attained a National Vocational Qualification (NVQ) to level 2 or above. The Manager said that there were normally two or three staff on duty. A member of agency staff was still being employed at the Home as a senior support worker but had worked here for the past three years and therefore provided continuity. Staffing levels recorded on the pre-inspection questionnaire were of a good standard. The staffing rota was not viewed at this inspection. The Manager said that staff recruitment had improved in recent months and there was a full staff team now. One staff file was seen and this included all the records required by the previous Schedule 2 of the Regulations. The Manager was not aware of changes to Schedule 2 of the Regulations and therefore could not have ensured that a thorough recruitment procedure was in place. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 18 The Manager described high levels of support, by United Response, for new staff on Learning Disability Award Framework (LDAF) training. It was not easy to quickly access information about staff training from staff files. The benefit of a ‘training matrix’ staff group record was discussed with the Manager. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 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 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) 42 The Health and Safety of service users was being promoted. EVIDENCE: The Manager confirmed she had just satisfactorily completed a National Vocational Qualification (NVQ) Registered Manager’s Award. The Manager said that an annual plan had been developed since the last inspection. Cleaning materials were being kept in a locked laundry cupboard along with Product Information Sheets as required by the Control Of Substances Hazardous to Health (COSHH) Regulations. Good food hygiene practices were being followed in the kitchen including the taking of refrigerator and freezer temperatures daily. The pre-inspection questionnaire showed that equipment maintenance was being carried out appropriately. It was confirmed that valves were fitted near all hot water taps to prevent scalding. In addition, bath water temperatures were being recorded by staff. Team meeting minutes confirmed that staff had been reminded of risks to fire safety and tripping caused by the 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 20 heating appliance cables seen at the last inspection. Notes of this training was not in staff files. 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 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 2 x x x 2 Standard No 22 23 ENVIRONMENT Score x x 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 3 x x x x Standard No 11 12 13 14 15 16 17 3 3 3 x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 2 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 8 Blunt Street Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x 3 C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 22 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 1 Regulation 4 Requirement The registered person must amend the statement of purpose to reflect the recently revised environmental standards (a copy of which must be retained at the home at all times).(Previous timescale was 29/2/04). The registered person must make available a Statement of Purpose that is personalised to 8 Blunt Street. Details of contracting arrangements relating to the service users’ accommodation, including the arrangements with the purchasing authority, must be kept at the home on individual files or in the service users own room within a copy of the service users guide, and be available for inspection.(Previous timescale was 30/9/04). The registered person must ensure that service users Individual Charter is fully completed. Risk assessments must be written regarding the two floor rugs identified in this report. Toilet paper and hand drying facilities must be provided in all Timescale for action 1 December 2005 2. 1 4 & Sch 1 1 December 2005 1 December 2005 3. 5 5(3) 4. 5 5 1 December 2005 1 October 2005 1 October 2005 Page 23 5. 6. 9 24 13(4)(c) 16(2)(j) 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 toilets at all times. 7. 24 23(4)(d) The registered person must provide all those staff who work both day and night shifts with fire training sessions at a frequency of at least twice a year. The registered person must audit all staff files against the recently changed Regulations and Schedules and ensure that the contents are as required. (Previous timescale was 28/2/05) 1 December 2005 8. 34 17(2) Sch 4.6(g) (revised) 1 December 2005 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 6 Good Practice Recommendations The registered person should develop a background history for all service users that will complement the range of assessment material already available.(This recommendation from 30 July 2003 was not assessed) Log entries should reflect the objectives outlined in review meeting minutes and be an ongoing source of information for reviews. Consideration should be given to the display of some core policies and procedures in a form more understandable to service users and that is domestically acceptable. All records, including body maps, should be signed and dated. The manager should review the environment on receipt of the psychologists report, with a view to replacing some pictures and making the environment more homely.(This recommendation from 14 February 2005 was still ongoing) Consideration should be given to providing service users with personal lockable space in their bedroom and a bedroom door key, following a risk assessment. The registered person should organise a programme of team development to strengthen the staff group.(This recommendation from 7 January 2004 was not assessed) The registered person should explore the availability of C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 24 2. 3. 4. 5. 6 22 23 24 6. 7. 8. 26 31 19 8 Blunt Street 9. 10. 11. 12. 13. 14. 21 36 32 35 42 43 annual health checks from the local primary healthcare services.(This recommendation from 7 January 2004 was not assessed) The funeral wishes of service users (or families) should be ascertained and documented on individual files.(This recommendation from 7 January 2004 was not assessed) The registered person should carry out annual appraisals for all staff.(This recommendation from 2 June 2004 was not assessed) 50 of staff should achieve a National Vocational Qualification (NVQ) to level 2 or above by 31 December 2005. The registered person should consider providing a ‘training matrix’ staff group record to give an at a glance overview of staff training. All elements of staff training should appear on staff files. A copy of the home’s financial plan should be available for inspection.(This recommendation from 7 January 2004 was not assessed) 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 25 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3QT 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 8 Blunt Street C02 C52 S19940 8 Blunt Street V242806 080805 Stage 4.doc Version 1.40 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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