Inspection on 01/02/06 for 9 Victoria Street

This inspection was carried out on 1st February 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

9 Victoria Street 26/09/07

9 Victoria Street 08/12/06

9 Victoria Street 09/11/04

9 Victoria Street 30/06/04

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 Victoria Street (9) New Brimington Chesterfield Derbyshire S43 1HY Lead Inspector Stuart Hannay Unannounced Inspection 1 February 2006 10:00 st Victoria Street (9) DS0000035806.V277695.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 Victoria Street (9) DS0000035806.V277695.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. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Victoria Street (9) Address New Brimington Chesterfield Derbyshire S43 1HY 01246 347590 02146 347594 Not given 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) Derbyshire County Council Linda Hurst Care Home 18 Category(ies) of Learning disability (16), Learning disability over registration, with number 65 years of age (2) of places Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: N/A Date of last inspection 14th June 2005 Brief Description of the Service: 9 Victoria St is a care home registered to provide personal care and accommodation for up to 18 adults between 18 - 65 with learning disabilities. The home is located in the village of Brimington on the outskirts of Chesterfield. A number of shops, pubs and other amenities are nearby. Derbyshire County Council owns the home. The accommodation is on two floors. There is a stair lift provided. 16 of the bedrooms are single accommodation, 4 of which provide ensuite facilities. One-bedroom is double accommodation. There are three communal dining and lounge areas. There is also a flat where service users can make drinks and snacks. There is a spacious garden to the side and rear of the building. Some limited car parking space is provided, although cars can also park on the road. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Six service users were spoken with during the inspection to ascertain their views of the home. The manager and one staff member were interviewed and a range of records related to the care of service users was examined. A short inspection was made of the premises to check previous requirements. This was an unannounced inspection which lasted 4.5 hours. It should be noted that the majority of service users were out on placement during the inspection and their views may differ from those at the home who do not attend regular placements. What the service does well: What has improved since the last inspection? A follow-up inspection visit in August 2005 noted improvements to the service users’ care plans and the majority of service users had a personal care plan in place – this highlighted their individual needs and what staff needed to do to meet these needs. Extra staffing hours had been made available to the unit in line with previous requirements and there were now 2 cooks in post. The records of administration of medication were fully completed with no omissions. Service users felt that the food had improved significantly. A number of building issues had been addressed and others were in the process of being completed. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Victoria Street (9) DS0000035806.V277695.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 Victoria Street (9) DS0000035806.V277695.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): 1235 The nature of the service means that service users cannot always be fully assessed prior to them being admitted. This may have implications for the staffing at the home. The Service Users Guide has additional information but some further information is still required. EVIDENCE: A recently admitted service user said that they had not had the opportunity to visit the home prior to moving in. This was due to their personal circumstances and also meant that the home did not have the opportunity to complete any pre admission assessments. There were aspects of this person’s behaviour that presented certain risks to themselves. It is the opinion of the inspector that it would be difficult for the staff team to be able to quickly change staffing routines to provide extra supervision if necessary. Whilst this person was considerably at less risk than they were in their previous situation, the admission highlights potential problems with the supervision and support of service users throughout the day. The home had received a detailed care plan for this person, which they were using until completing their own assessment. The Service Users Guide did not contain information to say that service users would have to purchase some of their drinks during the day. Victoria Street (9) DS0000035806.V277695.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): 6789 Service users are consulted about their care and the running of the home. However, their progress and participation is not fully recorded up-to-date in their care plans. Risk assessments are in place regarding most aspects of their lives. EVIDENCE: Service users spoken with said that they discussed their care with their keyworker on a regular basis. Whilst some were not sure what the care plan documentation was, it seemed that they had the chance to discuss what they wanted from the home and what help they felt they needed. Service users also said that they had had more regular service users’ meetings, independently of staff, with an external advocate if they wished. Unfortunately their involvement was not reflected in some of the care plans checked, which were not reviewed up-to-date. The manager said that the frequency of reviews depended on the needs of the service users, however it was not clear in some of the plans when the next review was due and there was no indication at what frequency they should be reviewed. Some of the entries in the care plans, including reviews, had not been signed or dated and it was difficult to measure progress. One service user’s review and weekly timetable contained very little information. As Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 10 noted above, whilst service users did feel that their opinion was sought on their care, there was little evidence of service user consultation in the care plan. It is acknowledged that some service users may have difficulty understanding the documentation but further work is still needed to involve people in this process. Risk assessments were in place for most of the service users. Victoria Street (9) DS0000035806.V277695.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): 11 12 14 17 Service users are involved in events and activities inside and outside of the home, however more focus is still needed on how to provide support and stimulation for people who do not attend regular placements during the day. The meals were varied, of good quality and appreciated by the service users. EVIDENCE: Seven service users were spoken with on the day of the inspection. Three of these people attended college or day placements but said they were on ‘days off’. The others said that they did not attend day centres or other placements. One person was over the age of retirement and did not feel it was appropriate to be working. He said that he was active and visited his wife three times a week and went to a car boot sale. Another person said that he had attended placements but no longer wished to. He said that he kept himself busy, going out everyday, shopping for himself and others. Another service user said that it did get a bit boring ‘just watching telly’ although they also felt that there was a friendly, relaxed atmosphere at the home ‘most of the time’. They said that they were able to do things independently or in small groups and sometimes did activities with their key workers. As noted in previous reports, the rotas are Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 12 primarily designed to support service users in attending outside placements – staff felt that increasing numbers of service users who stayed at the home during the day meant that the nature of the service was changing. Care staff numbers are at a minimum during the day when most people would be out on placements. There are still events organised by the home which service users said they enjoyed. It should also be noted that the views of the majority of the service users were not ascertained during this inspection as they were attending their placements. All the service users spoken with were pleased with the improvements in the quality of the meals provided. The menus seen reflected a variety of meals provided on a cyclical basis, which is regularly changed. Service users confirmed that they could have an alternative meal if they did not like what was on the menu. They said mealtimes were flexible and they were able to make suggestions about the food. Some of the service users who wish to have drinks, other than at set times, are required to pay for these by using the drinks machine – this practice needs to be stopped and free drinks provided at all reasonable times. The ‘flat’, the area where service users can cook and practice daily living skills was due to have been redecorated within days of the inspection. Victoria Street (9) DS0000035806.V277695.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): 18 19 20 Service users felt that personal care was provided in a respectful and dignified way. Healthcare records were fully documented and the home is pro-active in seeking help with health concerns. EVIDENCE: Two service users spoken with said that they received help with their personal care, mostly in the form of prompting. They were generally happy with this and felt that it was provided in a dignified and supportive way. One service user was not happy with her key worker and said that she intended to raise this with the manager. This was discussed, with the service user’s permission, with the manager, who said that the service user regularly changed key worker and would have no concerns in voicing her dissatisfaction with the staff member involved or the manager. Health needs were recorded in detail in the care plans and there were records of all appointments with healthcare professionals and any treatments prescribed by them. Changes in service users’ behaviour or health were referred quickly to external professionals and the home were proactive in this area. The MAR (medication administration records) sheets were checked and these had been completed appropriately – the system was not fully checked during this inspection. One service user said that the home looked after his medication and he was happy for them to do so. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 14 Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 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): This area was not inspected. EVIDENCE: Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 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): 24 25 26 27 The home was clean and tidy. Most of the previous requirements regarding the building had been addressed. Service users said that they were happy with their communal and personal space. EVIDENCE: Two bedrooms were seen with the permission of the service users. These were spacious rooms, well-decorated and furnished. All the service users asked said that they were happy with their rooms – they all had keys for their rooms, apart from one person had been assessed as not being able to look after a key safely. The communal areas were quite homely in appearance (the main lounge is large to be able to accommodate most of the service users), comfortably furnished and decorated to a good standard in most areas seen. One of the two bathrooms identified in previous reports had been redecorated and water damaged areas had been repaired. The ‘flat’ area was in the process of being redecorated on the day of the inspection. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 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 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 33 Staffing levels have improved significantly at the home since the last inspection but the allocation of staff over the 24 hour period still needs further review including the management time available. EVIDENCE: As noted in the additional inspection in August 2005, proposed changes to the rota, some of which had been implemented, had improved the staffing situation at the home. An additional 20 hour post had been identified and the recruitment of 2 cooks had relieved pressure on the care staff. Vacant posts were being filled and there appeared to be no major problems with long-term sickness or absence. One staff member interviewed felt that the nature of the service was changing as there were more service users in the home between 9 a.m. and 3 p.m. This has implications for the supervision and support of service users who remain at the home – on the morning of the inspection there was only the Manager and one Residential Social Worker (RSW) in the home (as well as auxiliary staff) and the RSW had to attend an external appointment with one service user. There were a least 4 service users in the home and the Manager also had the management tasks to undertake, which included a meeting with the police and other professionals regarding the safety of one service user, as well as dealing with the unannounced inspection from the Commission for Social Care Inspection. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 18 The service users felt that the staff were supportive and most said that they were friendly. As identified above, one person was unhappy with their key worker. All felt that they could discuss any concerns with the staff. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 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): 41 Records were stored securely and service users were informed of their right of access to their records. EVIDENCE: Information about service users was kept in secure areas in the home. There was written information about the rights of service users to access information about themselves and the fact that other professionals may also have the right to see the records. As noted above, some service users were not sure about their care plans but said they were consulted about their care. Some requirements from this section were not checked during this inspection and these are carried forward so that they can be checked on a later inspection. These refer to the effectiveness of the Quality Assurance system and problems associated with the difficulties of reconciling the aims and objectives of the service (which is to provide short to medium term care with Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 20 the aim of moving people onto more independent living) with the reality of the needs of some of the service users and the resources needed to support them. Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 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 Standard No Score 1 2 2 2 3 2 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 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 2 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 2 12 3 13 X 14 3 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x X X 2 2 3 X X Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 22 YES 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 YA2 Regulation 14 Requirement Wherever possible, the home must make their own assessment of potential service users in order to ensure that the home can meet their needs. This should take into account he needs of the existing service users. Free drinks must be provided at all reasonable times throughout the day. Service user plans must be reviewed with the service user and other relevant parties as agreed with the service user at least every 6 months or as changes occur, and updated to reflect changing needs. (Original timescale 30th June 2005) Staffing levels must be reviewed taking into account dependency levels and the assessed needs of service users. The numbers of staff on duty must allow for uninterrupted work with individuals; activities; community links and social inclusion and administration duties. (Original timescale 30th June 2005) DS0000035806.V277695.R01.S.doc Timescale for action 30/04/06 2 3 YA17 YA6 16 (i) 15 (2) (b) 28/02/06 30/04/06 4 YA33 18 (1) 30/04/06 Victoria Street (9) Version 5.1 Page 23 5 YA33 18 (1) 6 YA40YA39 12 (3) 7 YA27 23 (2) (b) Staffing reviews must include 30/04/06 supporting the service users who do not attend regular day placements. The policies and procedures of 30/04/06 the home must be appropriate to the setting of the home and cover standard 39.9. They must be reviewed and amended where necessary. Original timescale 1 February 2004 Upgrading and redecoration to the bathroom must be completed 30/04/06 as part of the homes development plan. Original timescale 1 April 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 YA8 Good Practice Recommendations The registered manager should consider ways that service users can further participate in the day-to-day running of the home and to contribute to the development and review of the service. There should be an assessment of individuals’ independent living skills and provision for development of these skills to be made. The registered person should ensure that service users have access to and can choose from a range of appropriate leisure activities. The home should be organised into clusters of up to 10 people by 1 April 2007. (Recommendation from previous inspection) The homes quality assurance systems should include whether the service has met their stated aims and objectives. This should involve service users. The registered manager should be able to demonstrate development for each service user, linked to implementation of the individual plan. 2 3 4 5 6 YA11 YA14 YA24 YA39 YA39 Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Derbyshire Area Office 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 Victoria Street (9) DS0000035806.V277695.R01.S.doc Version 5.1 Page 25 - 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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