Inspection on 18/10/06 for 8 Brantwood Road

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

8 Brantwood Road 24/10/08

8 Brantwood Road 29/11/05

8 Brantwood Road 13/04/05

8 Brantwood Road 20/01/05

8 Brantwood Road 02/08/04

8 Brantwood Road 17/02/04

8 Brantwood Road 08/07/03

Similar services:

Chesham House

Argyll House

Dorset Lodge

Acacia House

Falcon House

Dial House Nursing Home

Cromwell Avenue (9)

Abbey Lodge

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

CARE HOME ADULTS 18-65 8 Brantwood Road Luton LU1 1JJ Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 18th October 2006 2:35 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 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 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 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. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 8 Brantwood Road Address Luton LU1 1JJ 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) 01582 480642 Advance Support Ltd Louise Cawley Care Home 5 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (5) of places 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 29th November 2005 Brief Description of the Service: Advance Housing and Support Ltd is a charitable organisation providing services within the community to meet the needs of people who have either a learning disability or a mental health problem. 8 Brantwood Road is a semidetached house and is located near the town centre of Luton and overlooks the park. The home provides accommodation for five service users with mental health needs. All the service users have single rooms. The first floor has four bedrooms, a bathroom and utility room. The downstairs has one bedroom, a lounge and kitchen/diner, a toilet, separate smoking room and an office. There is also a small garden at the rear of the house. At the front of the building is a small driveway. The accommodation is not suitable for service users with mobility problems. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of the unannounced key inspection carried out on 18/10/06 over 2 ½ hours by pursotamraj hirekar. The method of inspection included review of outstanding recommendations, study of care plans, risk assessments, staffs’ files. Discussion with the service users’, staffs on duty, partial tour of the premises and observations. The manager and the deputy manager had coordinated the entire inspection. What the service does well: 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. The summary of this inspection report can be made available in other formats on request. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 6 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 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 7 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements to provide relevant information to prospective service users, to enable them to take a decision prior to their admission. EVIDENCE: The service user whose situation was case tracked had all the necessary information prior to making a choice of the home. The needs and aspiration of the service user were systematically assessed. The service user had signed the terms and conditions with the home. The statement of purpose had detailed information. However, the staff section needed update to include all the recently recruited staffs details. On this inspection 2 service users’ were case tracked. Service user –1 and service user –2 had trial stay, detailed preadmission assessments were carried out and contracts were signed. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 8 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including visit to this service. The risk assessments, needs assessment and care planning was comprehensive that helped staffs’ to deliver care effectively. EVIDENCE: The care plans were prepared in consultation with the service users. The care plan covered daily living skills, independent living, outdoors activity, cooking skills, manage money, personal needs, medication and the physical and mental health. Service user was encouraged to take part in the routine activities of the home including providing support to promote independent lifestyles. Service user – 1 multi-disciplinary care plan review was dated 30/06/06, participants’ include service user, doctor from crisis team and social worker. There was no evidence of monthly review report after 18/7/6 and the link worker meeting reports were dated 7/10/6, 31/8/6 and 2/8/6. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 9 Service user – 2-risk assessment with regard to aggressive behaviour towards staffs and refusing to take daily medication as per self-medicating regime was carried out and action plans prepared. A letter was written by the manager on the 15/05/06 to the social worker, of the community mental health team at calnwood court, Luton expressing concerns about the service user’s behaviour towards staffs and the other service users at the home. A meeting was held on 30/08/06 by the home manager and team leader and the care manager from the social services to discuss the behaviour problems of the service user towards staff and the other service users’ at the home. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager and the staffs’ have encouraged service users’ to help them lead a normal life. EVIDENCE: The home was providing appropriate opportunities and support to service users to help them achieve skills that lead to a better quality of life. The various opportunities and activities the service users engage in include attending college, learning carpentry skills, participating in cooking meals at the home, watching television, reading and going to the gym once a week. The Service users spoken to, enjoy college activities and feel happy about the skills they have learnt. The service user case tracked was in regular touch with the family members and spends weekends with them. Menu was prepared on a weekly basis and cooking was carried out with a staff’s support. The service users enjoyed their meals and participate in cooking activities. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements for the personal and health care of the service users’. However, the home must have a senior person in the absence of a manager to avoid any risk of harm and abuse of service users’. EVIDENCE: On this inspection 2 service users’ were case tracked and their details are as follows: Service user – 1 risk assessment was carried out on 27/06/05 reviewed on 12/07/06 which detailed relapse, drug abuse, medication, cooking for self and others and hallucinations. Health and safety risk assessment, which was carried out by the manager on 15/09/06 detailed self-medication. Care plan dated June 06 detailed nutritional, personal-bath, laundry, hair, nails, dentist, work and leisure – work, gym, cinema, Sunday dinner, visiting dad, finances and self management. Weight chart recorded monthly weight the latest one was on 3/10/6. Medical appointments with the psychiatrist last entry were of 14/07/05 no record thereafter. The staff member on duty maintained daily duty log. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 12 Service user –2 risk assessment carried out on 16/05/06 detailed information regarding leaving the project with informing the staffs and not taking medicine, 30/06/06 aggressive behaviour towards staff. The home manager had written a letter dated 24/05/06 to the social worker, social services regarding concerns about the service users’ behaviour. A meeting was held on 30/08/06 with manager, team leader, and service user and with the care manager from social services regarding the behaviour of the service user. Care plan was updated on 17/07/06 detailed information about life skills – cooking, shopping, budgeting, cleaning and washing, other life skills, maintain health care agreed action, personal safety and finance, relationships, activities hobbies and interests, personal care – washing, bathing, foot care, hand care, dentist, nutritional needs, religious and cultural needs. The latest medical appointment was dated 03/07/06 and weight was last taken on the 3/10/06.On the 17/10/06 a incident that had happened with a service user regarding an incident at the home the matter was reported to the police and thereafter no senior staff or the social service personnel had spoken to the service user and had taken any steps as of this inspection day. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had made appropriate arrangements regarding complaints policy and procedure. EVIDENCE: There were no complaints recorded in the complaints register. 2-service users file had complaints policy and procedures. The random inspection carried out on 18/05/06 evidenced that the homes complaints procedures file was available in the communal lounge which was normally used by all the service users. The complaints and concerns made by the service users were addressed appropriately by the manager. Please refer environment outcome group for more details. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was maintained clean and tidy, free of offensive odours. EVIDENCE: The random inspection carried out on 18/05/06 evidenced that complaints made by the service users’ that mouse were found in the lounge and front room. To this effect, the home had carried out a risk assessment of the premises and used mouse poison, mousetrap and installed 3 sonic plugs to emit high frequency noise to keep away the mouse. EHO, Luton Borough Council’s services were used and a mesh was placed covering over the airbricks and point of the side brick wall and front wall vents. Service users’ spoken to, have confirmed that now the mice do not come any more. The home now had bought new hand gloves for use in the kitchen, new cutlery plates, cups, saucers and side plats and bowls. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 15 The weekly hot water temperatures checks were taken every Monday Wednesday and Friday afternoon, in effect every check point (kitchen sink/service users bed room) temperatures were taken once a week . The recorded temperature varies from 41 degree celcius to 51 degree celcius. On the day of this inspection, the date recorded on the weekly hot water temperature was 18/05/06 thursday, when asked why the temperature was taken on Thursday when it is supposed to be taken on Wednesday, the staff member said that she had taken the hot water temperature on Wednesday ie; 17/05/06 and the date was recorded wrong. The staff member then corrected the date on the weekly hot water temperature sheet. The staff member was asked to show how she woud take the hot water temperatue, she filled hot water from the kitchen sink in a mug and then picked up a hot water temperature thermometer, after a while she declared that the thermometer was broken she cannot take the temperature. She said the thermometer was ok yesterday 17/05/06. Later the manager confirmed that the hot water temperature thermometer was ok and said she will discuss with the concerned staff member (who had completed her duty hours and left the home) next day. The staff on duty said that two service users (BG & AB) use hot water with temperatures of 50 degree celcius, if the staff reduce the hot temperature the service users would complain. Fire exit checks records indicated that they were regular, water temperatrure checks are done every monday, wednesday and friday of kitchen, bath and wc. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staffs, were qualified, trained and have good working relations with the service users’. EVIDENCE: The random inspection carried out on the 18/05/06 had evidenced that the support staff who was on maternity leave had reported on duty. The home had appointed a deputy manager who will be working between two homes. The staff deployment records indicated that, currently, the home had 2 full time support staff, 1 partime support staff and part time deputy manager and supernumenary manager. The manager confirmed that, there were no staffing issues. The service users confirmed that the staff were cooperative and attend to their needs when required. On this inspection, the manager was on leave and the staffs’ files were not accessible as they were locked. Staff - 1 joined in February 2006, working as support worker received training in health and safety, first aid, food and hygiene, general welcome to advance trg, advance housing scheme, how to 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 17 deal with violence, aggression and with learning disability. Supervision was held every three months but the records were not accessible on this inspection. The last supervision was held in September 2006, the staff said. Staff- 2 received training in medication, manual handling, responding to violence and aggression and risk practice issues. Staff – 3 had received training in first aid, medication, and manual handling. Staff – 4 received training in medication. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is adequate. The judgement has been made using available evidence including a visit to this service. The recently introduced improvements to manage the home effectively were a positive step forward. The home must sustain the morale of staffs’ and care delivery. However, the home must have a senior person in the absence of a manager to avoid any risk of harm and abuse of service users’. EVIDENCE: The random inspection carried out on 18/05/06 evidenced that Service user care plan were reviewed and the revised careplan have taken into account the changing needs of the service users and appropriate action plans have been detailed except. The care plan have been signed by the key worker and the service user. However, the manager also need to sign the plan. The staff supervision was carried out on 10/04/06 and the manager was working with 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 19 the staff to develop a training calender. The staff and the service users link working session needed to be regularised and recorded. With the addition of new staff member, the manager had been taking appropriate measures to ensure the service users needs were adequately met. The front wall vents that needed mesh cover over them need to be attended on priority. Please refer environment outcome group for additional information. The manager was on leave from 16/10/06 to 21/10/06. There was no information at the home what to do in need of urgent help. The incident of 17/10/06 with regard to a service user, the staff member on duty had called in the police, instead a senior staff to handle the situation and talk to the service user. The social services were contacted, who could not come as promised to come at 11.00am on the 18/10/06 and said that they would confirm when they would come. The staffs on duty were not aware whether the issue was reported to the commission. At 5.30pm on this inspection, the home received a telephone call with the information that outreach team and doctors are coming tomorrow for the service users’ review. The home had introduced quality assessment action plan for internal monitoring and to make improvements of the care delivery, the information was recorded systematically. 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 20 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 3 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 1 3 X 3 X 3 X X 1 X 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 21 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. Standard YA19 Regulation 12(3) Requirement Timescale for action 15/11/06 2. YA42 13(6) 15/11/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 8 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Brantwood Road DS0000014993.V316319.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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