Inspection on 13/10/06 for 94 Tennyson Road

This inspection was carried out on 13th 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 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

94 Tennyson Road 12/05/09

94 Tennyson Road 01/07/08

94 Tennyson Road 15/01/08

94 Tennyson Road 28/08/07

94 Tennyson Road 03/02/06

94 Tennyson Road 19/10/05

94 Tennyson Road 11/03/05

94 Tennyson Road 22/12/04

94 Tennyson Road 29/03/04

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

CARE HOME ADULTS 18-65 94 Tennyson Road Luton LU1 3RR Lead Inspector Mr Pursotamraj Hirekar Unannounced Inspection 13th October 2006 01:15 94 Tennyson Road DS0000014976.V315831.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 94 Tennyson Road DS0000014976.V315831.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. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 94 Tennyson Road Address Luton LU1 3RR 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 484079 Advance Support Ltd Ms Ann Dalton Care Home 4 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2006 Brief Description of the Service: 94 Tennyson Road is a semi- detached house situated in a quiet residential road in south Luton. The home is owned by Advance Housing and Support Limited and provides accommodation for four service users with mental health needs. The home has four single bedrooms and a bathroom and toilet on the first floor. The ground floor contains a lounge, dining room, toilet laundry room and a kitchen. The service users use a garden at the rear of the house in the summer months. There is a parking area at the front of the house. The home is within walking distance of the town centre and two local parks and the bus stop. Mrs. Ann Dalton is the current registered manager. The current registered manager is Mrs. Ann Dalton. The fee was about £580.17/-. 94 Tennyson Road DS0000014976.V315831.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 13/10/06 over 4 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: 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 6 The home must ensure that the assessment of the service user’s needs and risk assessments are revised at any time when it is necessary to do so having regard to any change of circumstances. This was in particular reference to 1 service user. The home must ensure that there was proper provision for health and welfare of service users’. This was in particular reference to 1 service user. The home must make arrangements to receive where necessary, treatment, advice and other services from any health care professional. This was in particular reference to 1 service user. The home must carry out a robust review with the service user, representatives and professionals and incorporate into care plan for reference and appropriate care delivery. This was in particular reference to 1 service user. 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. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 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 statement of purpose and the service users’ guide was reviewed with the service users’ on the 19/09/06, which the manager had planned to complete the print version before 23/10/06, which was received by the commission. The admission date of service users were recorded and signed appropriately. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. 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, except for 1 service user who was on adhoc arrangements for care delivery. The home must protect the service user from neglect and risk of harm. EVIDENCE: On this inspection 2 service users’ were case tracked. Service user – 1 care planning process and review was regular until the service user was hospitalised. Doctor reviewed CPA on 30/03/06 and 03/04/06 with care coordinator, service user and staff member. On the 11/05/06 assertive outreach team leader, care coordinator; service user and the staff have participated in the review. On the 05/06/06 registered social worker, care coordinator, psychiatrist, doctor, service user and the staffs have participated in the review. The service user was hospitalised and discharged on the 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 10 11/10/06 and a review was planned for the week starting 16/10/06, during the interim 5-day period the home did not have the care plan to refer for providing the services. However, the social worker from the social services was in regular touch with the home enquiring about the status of the service user. The social worker had visited the home during the inspection and handed over a packet of medicine to the staff member and said this medicine needs to be administered to the service user. When, asked on what basis the medicine needs to be given to the service user in the absence of care plan and hospital discharge advice, the social worker had said that the care plan was reviewed and a copy of the same would be given to the home and this was a mistake and apologised for the same. The home must provide care delivery to the service user only on the basis of care plan, talking into account the changing needs and aspirations of the service user who was discharged from the hospital. The home must not have any adhoc arrangements for care delivery to protect the service user from neglect and risk of harm as in the case of service user – 1. Service user – 2 care plan was reviewed by the service user, manager, link worker, social worker and the auntie of the service user dated 15/06/06 and was signed by all the participants. The service user had said on this inspection that all the staff took care of him well, he had no problems and he was fine. On a general enquiry rest of the service users’ care plans were reviewed as scheduled and updated. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. 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: In consultations with the service users, the home had developed a daily schedule of home activities that they attended which included dust polish lounge, Hoover hallway and lounge, set table for lunch, wash up after lunch, empty dishwasher, emptying bins, clean all surfaces after breakfast in kitchen and prepare vegetables, bins out the front and return, room and laundry day and post office day which the service users’ do on rotation. The staff encouraged the service users to improve their daily living skills in personal hygiene, shopping, budgeting, and healthy eating, visiting the bank and the post office. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 12 The service users’ spoken to have stated, that they had enjoyed stay at the home and the staff were supportive. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is poor. 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’; except for 1 service user who was on adhoc arrangements for care delivery. The home must protect the service user from neglect and risk of harm. EVIDENCE: The home had made appropriate arrangements for conducting risk assessments of the service users’ in the area of personal hygiene/self neglect, health and safety, finances, using electrical appliances, cooking, staying in the bed, outdoor health and safety, use of cleaning materials, motivation, manage own shopping, maintaining family contact, smoking, use of public transport and eating. These risk assessments would be reviewed every 6 months or as required. The staffs’ in response to the risk assessment, assessed needs, challenging behaviour programmes and care plan provided personal and health care support. The range of support included personal hygiene, daily routine good 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 14 habits, nutritional needs, work and leisure needs, healthy eating, cooking, budgeting, including monitoring of weight, mental health medication, dental/ optician and dietary requirements. The home had a comprehensive medication policy and procedures, the designated staff administered medication, mars sheet were maintained, and medicine was stored in safe place. Staffs have good working relationships with the service users’ and with the external professionals such as care coordinators’, social workers and doctors and the psychiatrists. Despite the home’s comprehensive medication policy and procedure, in practice with 1 service user who was discharged from the hospital on the 11/10/06 the social worker from the social services had hand delivered medicine to the staff member of the home with oral instructions, during this inspection, which was to be administered to the service user in the absence of the care plan. The home must not have any adhoc arrangements for care delivery to protect the service user from neglect and risk of harm. Please refer for additional information on this service user under individual needs and choices outcome group. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. 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 a comprehensive complaints policy and procedures. EVIDENCE: The concerns and complaints policy and procedures were comprehensive and all the service users’ have access to the same and a copy was also displayed on the notice board in the communal area of the home. There was no complaint since the previous inspection. However, 1 service user had problems of driving the car and the home had taken appropriate measures after the reported incident of 08/06/06 in consultations with external professionals to protect the service users from risk of harm and abuse especially driving the car. Service user refused to sign the care driving risk assessment. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. 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 home had maintained log, for regular maintenance and any repair that need to be fixed at the home, which had detailed, all the relevant information required. The home had carried out risk assessments of the premises which included; outdoor health and safety, general working environment, fire, gas, electrical, water, hygiene and health, medication accidents, COSHH and kitchen. The company now had concluded and implemented the smoking policy. The home had through consultations with the service users’ and has implemented the smoking policy ‘we will only smoke in the kitchen of this home, and also accept that; if food is being prepared or eaten, that we will smoke in the utility room of the home. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 17 The home was clean and free of offensive odours. The manager said that the carpets were regularly shampooed. Fridge/freezer and smoke detectors checks were recorded for every day. Hot water temperature recorded weekly. Weekly fire tests done by the staffs were recorded and in addition to fire and security engineer routine fire alarm maintenance every three months. The home must regularly shampoo the carpets in the lounge and the doorway. The home had fixed a handrail on the stairs leading to the office; kitchen units that include new sink, new florescent tube and new extractor fan were replaced. Dinning flooring was in the process of refurbishing. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. 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 home had made appropriate arrangements for the assessment of staffs’ training needs, developing a training calendar and implementing the same. Some of the training that the staffs were provided include; in-house medication assessment, administration of medication, response to violence and aggression in mental health, food hygiene, welcome to advance, personal safety, health and safety, introduction to mental health, POVA, care planning, effective communication, dementia, challenging behaviour, and anger management. The home had promoted a staff member to the position of deputy manager, who had completed nvq3 and has been in the care industry for 5 years working with mental health clients. Staff supervision was done once a month regularly. Staff deployment was specific to the home. The manager and the staffs’ work as a team that benefit the service users’. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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. 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. The home must not provide service-to-service user without having a robust care plan, to avoid any neglect and risk of harm. EVIDENCE: The manager and staffs’ work as a team that benefits the service users’. The annual business plan was dated 05/09/05 and was due to be reviewed for the year 2006/07. The home had planned to carry out a survey and take the opinion and feedback from the service users’, service users’ family, social services and all the external professionals the home was in contact with. The 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 20 manager had planned to complete the preparation of the annual business plan by the end of November 2006. The home had introduced in-house quality assessments plan, which worked well till 04/06 and due to the work pressure at home this, was not continued and the manager was planning to continue the same from 10/06. The staffs’ supervision was regular. Staffs monthly meeting and annual staff appraisals were regular. The manger need to be more assertive with regard to 1 service user who was sent to the home by the social services- mental health team with out a copy of the changing needs assessments and care plan. The manager must have an interim care plan till such time the care was reviewed and detailed care plans was prepared, and avoid any adhoc care delivery to protect the service users’ from risk of harm and abuse. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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 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 1 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 1 X 3 X 3 X X 1 X 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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 YA6 Regulation 14 (2) Requirement Timescale for action 15/11/06 2. YA19 12(3) 3. YA20 13(1) b 4. YA42 24 The home must ensure that the assessment of the service user’s needs and risk assessments are revised at any time when it is necessary to do so having regard to any change of circumstances. This was in particular reference to 1 service user. The home must ensure that 15/11/06 there was proper provision for health and welfare of service users’. This was in particular reference to 1 service user. The home must make 15/11/06 arrangements to receive where necessary, treatment, advice and other services from any health care professional. This was in particular reference to 1 service user. 15/11/06 The home must carry out a robust review with the service user, representatives and professionals and incorporate into care plan for reference and appropriate care delivery. This was in particular reference to 1 service user. 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 23 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 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 Page 24 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 94 Tennyson Road DS0000014976.V315831.R01.S.doc Version 5.2 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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