Inspection on 01/12/05 for 82 Chaucer Road

This inspection was carried out on 1st December 2005.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

82 Chaucer Road 14/05/08

82 Chaucer Road 12/01/07

82 Chaucer Road 20/02/06

82 Chaucer Road 19/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 82 Chaucer Road Bedford Beds MK40 2AP Lead Inspector Linda Lilley Unannounced Inspection 1st December 2005 02:00 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service 82 Chaucer Road Address Bedford Beds MK40 2AP 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) 01234 216319 Caretech Community Services Limited Mrs Karen Elizabeth Barringer Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Number of places: 6 Age: 18-65 years Category: All persons admitted to the home must have Learning Disabilities as their primary assessed need. No service users with additional physical disabilities shall be admitted, unless it can be demonstrated that the home can meet their needs by way of accessible private and communal space and appropriate aids/adaptations. The manager must obtain a qualification to level 4 NVQ in care by December 2005. 19th October 2004 5. Date of last inspection Brief Description of the Service: 82 Chaucer Road was first registered in June 2004 as a care home for up to six adults with learning disabilities. Caretech Community Services Limited who provides a number of homes for people with learning disabilities nationwide owns this home. The stated purpose of the home is to provide care and support to people who have diverse needs associated with their learning disability, such as behaviour that challenges needs on the autistic spectrum and people who require alternative communication systems. The home is not suited to people with mobility problems although ground floor accommodation is available. The home is a refurbished Victorian villa in a residential area on the west side of Bedford. Accommodation comprises of a large lounge, dining room/conservatory, kitchen, laundry room and office on the ground floor. All bedrooms are for single occupancy and have en-suite facilities. There are bathing and toilet facilities on both floors. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection visit took place in the afternoon and evening of December 1st 2005. This visit followed a three hour period of review and preparation that included reviewing previous reports, reviewing information from other stakeholders, and documentation received in support of the process and preparing an inspection plan. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting two Service Users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. Six Service Users, and two members of staff were spoken to during the inspection visit. A partial tour of the premises was also completed and a review of the documentation and records required to be kept in a care home undertaken. This inspection report additionally addresses specific areas where requirements and/or recommendations were identified at the previous inspection. What the service does well: What has improved since the last inspection? The Registered Manager has obtained a Makaton Vocabulary “Writing with Symbols “(2000) computer package, which she is using to convert the current 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 6 policies, documents and individual Service User information and contracts into pictorial and symbols suitable for the Service Users. A dietician confirmed the home is offering an appropriate menu and that the dietary needs of the Service Users are well catered for with a balanced and varied selection of foods available that meets the Service Users tastes and choices. The Service Users are involved in decisions about their lives and are supported to be involved in a variety of activities, within a risk assessment framework. The staff files seen indicate that the home has robust recruitment procedures. 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. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. 2. 3. 4. 5. Since the last inspection progress has been made to ensure the Service Users guide, contract and key policies are available in a format suitable for the Service Users to understand. Service Users undergo a robust assessment process, including having an opportunity to visit the home and meet the other Service Users. This ensures their needs can be met, they would be compatible with the other home Service Users and they would be happy to live in the home. The “Statement of Services” contract signed by the Company Director, the Service User and a family member provides clear information regarding the terms and conditions of residency for each Service User. EVIDENCE: The Registered Manager has obtained a Makaton Vocabulary “Writing with Symbols “(2000) computer package, which she is using to convert the current policies. documents and individual Service User information and contracts into pictorial and symbols suitable for the Service Users needs. This work is in progress, but had been delayed due to an initial lack of access to a computer at the home. This has now been resolved and the manager has had a computer in the home since November 2005. Evidence was seen of an individual Service Users communication book, using pictures and symbols to indicate activities re staying at home or going out, and a Service Users saving /spending plan using the same method. The Service Users files seen contained appropriate information including, social and family history and determination of the Service Users personal lifestyle preferences and wishes regarding the care to be provided. Evidence was seen of risk assessment being incorporated into the Service Users assessment and plan of care and of these being discussed with the Service User. The risk assessments provided clear 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 9 information for staff to enable them take appropriate action to reduce any risk to a Service User during their activities. The Service Users contracts seen contained clear information regarding the terms and conditions of residency, including what was included within the contract price and what was to be funded by the Service User. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 10 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): 6.7.9.10 There is clear and consistent care planning system in place to provide staff with the information they need to satisfactorily meet the needs of the Service Users. The Service Users are involved in decisions about their lives and are supported to be involved in a variety of activities, within a risk assessment framework. Staff and Service Users are aware of the need for confidentiality. EVIDENCE: Within the two care plans reviewed, there was comprehensive and detailed information relating to all aspects of care. Particular difficulties were highlighted and there was good guidance for staff on specific intervention, for example how to recognize triggers of challenging behaviours and how to diffuse potential arising situations. Care plans are signed by Service Users and they contained pictures to enhance understanding as well as being written in the first person to encourage ownership by the Service User. Each Service User had a document telling staff what they liked to do and what they didn’t like to do and how staff could help them achieve this. One Service User had a pictorial “saving and spending plan” that she was using to help her save a set sum of money over a period of weeks to enable her to purchase of a “game boy. Risk assessments are undertaken and the outcomes contain clear guidance for Service Users and staff related to each element of the plan of care. There are systems in place to ensure the daily record is cross referenced to the plan of care, the monthly review of care, and the monthly key worker report. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 11 Observation of staff in the home highlighted they were aware of the need for confidentiality, for example asking a Service User to leave the room as we were going to be talking about another Service User, and keeping the Service Users files within the office. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 12 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): 11.12.13.14. 17 Social activities, leisure activities, educational opportunities and the daily routine within the home are managed well and provide a variety of opportunities for Service Users to maintain appropriate and fulfilling lifestyles. Dietary needs of the Service Users are well catered for with a balanced and varied selection of foods available that meets the Service Users tastes and choices. EVIDENCE: Discussion with Service Users and observation during the visit highlighted they took part in wide range of activities, including, shopping trips to Milton Keynes, attending the Day Centre, going to the cinema, attending College and undertaking appropriate courses, working, for example doing a paper round, as well as individual activities in their own rooms, for example watching videos, and completing puzzles. The staff supported individual choices for the Service Users in terms of their individual lifestyle whilst helping them to understand the constraints of living with other people, and the need for compromise and consensus at times. Service Users were encouraged to share what they had been doing during the day as they returned home and there was lively and positive interaction between Service Users and Service Users and staff. Service Users were encouraged to be involved in meal preparation and a 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 13 recent letter seen which was commissioned by the Manager from a visiting Dietician confirmed the home was offering an appropriate menu and that the dietary needs of the Service Users are well catered for with a balanced and varied selection of foods available that meets the Service Users tastes and choices. This was a recommendation from the previous inspection. Service users’ spoken to were happy with the support and encouragement provided by the staff of the home to maintain good relationship with their family members. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 14 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): 18. 21 The arrangements for dealing with a Service Users wishes regarding illness, and death are clearly communicated to the staff. EVIDENCE: Service users in the home required varying levels of support with their personal care. Care plans gave details of their preferred care and how they can be involved in their own personal care. No Service Users currently needed any specialist equipment. There was also evidence of information regarding the Service Users medical condition, their drug history and any current medication. No Service User had attended and Accident and Emergency department since the last inspection. Within the Service Users plan of care a document was seen entitled “Clients wishes after death” this clearly states out the Service Users wishes, whom they wish to be involved and the process that would wish to happen in the event of their death. The home had information available for staff on different cultural and religious customs. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 15 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): These standards were not assessed at this inspection. EVIDENCE: 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 16 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): 25 26.27.28 The standard of the environment currently in use within this home is good and provides the Service Users with an attractive and comfortable place to live. However the two new rooms within the extension, (not yet in use), need to be assessed to ensure they would provide 12sq.m of useable space sufficient to meet the Service Users needs. EVIDENCE: Five Service Users bedrooms were visited and were found to be of an appropriate size and contained suitable furnishings to meet the Service Users needs. Service Users said they had chosen the décor and furnishings. They also contained many personal belongings and evidence of the Service Users hobbies and interests. All service users had en-suite toilets to their bedrooms. In addition the home had three bathrooms, including a ground floor facility. The lounge area was warm and comfortable and well used by the Service Users and staff to relax and share their experiences of the day. The areas of the home visited were clean and well maintained. The two rooms in the new extension were visited and on visual inspection appeared to have less than 12 sq.m of useable floor space. The rooms are long and narrow with an entrance hall area, which could not be used for furniture as the door of the room opens inwards and requires this space to be free. The rooms have an en-suite toilet. The Manager indicated she had raised her concerns with the Company Area Manager regarding the size of the rooms when she saw the foundations being laid, and the walls erected, she also said she felt the rooms were very small 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 17 compared with the other rooms in the home. The plans for this extension are currently with the CSCI and the Manager is awaiting approval to use the rooms and increase the number of registered places from 6 to 8. A review of the suitability of these two rooms has been made a requirement of this inspection. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32.34.35. The home has robust recruitment procedures and an effective education and training programme in place that ensures the Service Users are protected and cared for by appropriately trained staff. EVIDENCE: Staff files reviewed contained evidence of application form, interview checklist, references, job description, photograph, copy of passport, induction process and ongoing training records as well as records of monthly supervision sessions. The home provides access for staff to Induction Foundation training, then NVQ level 2 3. And 4 as appropriate. The Home Manager is an NVQ assessor, and over 50 of staff have an NVQ`level 2 qualification or above. All staff attends mandatory training, including Fire, Moving and handling, and Food hygiene. The Home Manager provides in house training sessions for staff on subjects such as “Autism”,” and Epilepsy” and Non- violent crisis intervention. She is also considering purchasing a Computer Assisted Learning programme for staff on these subjects. Staff also attends training sessions offered by the trainers provided by the Company on subjects such as “Recognising and Dealing with Challenging Behaviour”. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37.38. 39 The manager provides clear leadership, based upon knowledge and experience and includes the team in decision-making regarding the developments within the home. The quality monitoring system in place does not provide information to the Service Users and Stakeholders regarding the outcomes of the audit process and any changes implemented as a result of the audit. EVIDENCE: The manager has significant knowledge and experience of working in and managing services for people with learning disabilities. She has completed her level 4 NVQ in care and is awaiting the results. She is also undertaking a Degree in Autistic Care at the University of Birmingham. The Deputy Manager has also completed NVQ`level 4 in Care. Staff spoken to confirmed that the manager’s style was open, positive and inclusive. This was observed as staff readily approached the Manager for advice and the discussions that took place between the Manager and staff highlighted the process of running the home are open and transparent. Team meetings are held monthly and the minutes of the meetings seen indicated staff are involved in decisions regarding the home. The home has an established quality monitoring system, which included six82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 20 monthly audits by an independent consultant. The results of these audits are feedback to staff at the “Team Brief” sessions and monthly Team meetings. A decision has been made not to hold formal Service User meetings as it is felt that due to the nature of the Service Users this may trigger elements of challenging behaviour. However Service Users views are gained through 1:1 consultations. Currently Service Users, families and other stakeholders do not receive information regarding the outcomes of any quality monitoring or any changes implemented as a result of an audit. This has been made a recommendation of this inspection. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 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 3 3 3 3 3 Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score x 3 3 3 3 x x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 82 Chaucer Road Score 3 x x 3 Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x x x DS0000060926.V266798.R01.S.doc Version 5.0 Page 22 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 YA25 Regulation 23.2(f) Requirement The Registered Manager must in review the proposed space to be provided within the two new bedrooms in the new extension to ensure they would offer the Service User 12sq.m of useable space sufficient to meet their needs. Timescale for action 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA39 Good Practice Recommendations The quality monitoring system in place should provide information for the Service Users and Stakeholders in an appropriate format, regarding the outcomes of the audit process and any changes implemented as a result of the audit. 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF 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 82 Chaucer Road DS0000060926.V266798.R01.S.doc Version 5.0 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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