Inspection on 12/03/07 for 97a Shurdington Road

This inspection was carried out on 12th March 2007.

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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 97a Shurdington Road Cheltenham Glos GL53 0JQ Lead Inspector Kath Houson Key Unannounced Inspection 12th March 2007 09:30 97a Shurdington Road DS0000067016.V333032.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 97a Shurdington Road DS0000067016.V333032.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. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 97a Shurdington Road Address Cheltenham Glos GL53 0JQ 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) 01242 578922 F/P 01242 578922 www.brandontrust.org The Brandon Trust Ms Marie Morrison Care Home 5 Category(ies) of Learning disability (5), Physical disability (5), registration, with number Sensory impairment (1) of places 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of the home has four bedrooms which: 1. To reduce numbers to four (4) places when a vacancy occurs. Date of last inspection 21st February 2006 Brief Description of the Service: 97a Shurdington Road is a large detached bungalow that provides service users accommodation for adults with learning and physical disabilities who may have complex needs. The home is situated within easy access of Cheltenham town centre. The home benefits from being on the main route into Cheltenham with easy access to public transport. The home has the use of its own vehicle which is suitable for wheelchair users. The home is run by Brandon Trust and Advanced Housing manage the property. Accurate information about fees were provided and range from £69.95 - £136.91 per week. The assessemnt of fees are calculated according to needs assessment. All personal items are not included by the fees and the home does have a budget for petrol and activities. Prospective service users are given information about the home including copies of the Statement of Purpose and Service Users’ Guide which includes some information about what is covered by fees. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The judgements contained in this report have been made from evidence gathered during the inspection, which included a visit to the service and takes into account the views and experiences of people using the service. The term “service users” will be used throughout this report. The unannounced inspection took place on one day in March 2007. The registered manager was available during the inspection, and was able to assist and provide all relevant documentation on request. The members of staff were able to assist in a positive manner creating a working partnership with the Commission for Social Care Inspection (CSCI). Twenty-one core key standards were examined. This included an examination of documentation; two service users were case tracked (this is a method used to carefully examine and link various aspects of the service users’ care within the home). A tour of the environment is to explore the physical side and obtain a visual account of the home. A short discussion with a staff member formed part of the inspection and a short succinct feedback was given to conclude the inspection visit. I would like to extend my thanks to the service users, staff and management for their assistance with the inspection. What the service does well: What has improved since the last inspection? What they could do better: Update statement of purpose to reflect the objectives of the home. This can be produced in any format the home may wish as long as it is accessible to all users’ of the service. Regular monthly visits need to be more consistent. The policies and procedures need to be up dated to include the new provider details. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 97a Shurdington Road DS0000067016.V333032.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 97a Shurdington Road DS0000067016.V333032.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): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Potential service users needs are assessed prior to admission into the home. EVIDENCE: The home ensures that prospective users have the relevant information when making an informed choice about their place of residence. The admissions procedure is individualised and is contained in service users files. There has been no new admissions into this service since the last inspection. The providers Brandon Trust have developed their own Personal Care Planning (PCP) document that consists of relevant items that would be important to the individual service user. For instance, if the users have a particular cultural requirement the service ensures that steps are taken to meet those needs. The gathering of information is additionally pulled together with assistance from other sources such as family, health professionals and friends. The manager has encouraged the staff members to use the PCP on themselves to demonstrate how the plan would work with different examples. This is good practice, as this would provide the staff team with extra skills when completing the person centred planning document where diverse and cultural needs are evident. Additionally the understanding of what is important to potential users whose needs may differ from the norm. 97a Shurdington Road DS0000067016.V333032.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 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ care files are regularly reviewed. The staff team support the service users with the decision making process. Risk assessments are individualised and monitored. EVIDENCE: Supporting service users with complex needs and communication difficulties is the responsibility of the members of staff. Selected care files were examined. The staff team with the use of total communication methods are able to provide and support service user’s choice. The involvement of other health professionals ensures that health needs are reviewed and updates are recorded. Some of the care files demonstrate the best ways in which to communicate with those with limited communication skills. An example, the uses of gestures, the staff use body language such as being at eye level. Input from the speech and language therapist assists both the staff and 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 10 service users that enable and enhance coping skills when having to use physical objects. Use of flow charts also shows dates of reviews. On observation staff appear to approach and talk to the service users with dignity and respect. The respect of their rights was evident. Such as the service users who wish to sit out in the garden are supported. This demonstrates that the service users are supported with the decision making process. Selected care files appear to have appropriate risk assessments that are individualised and according to lifestyle. The care files show good recording and risk assessments based on need. For instance service users with epilepsy are monitored. This is good practice as this demonstrates that risk is minimised and service users are kept safe during an episode. 97a Shurdington Road DS0000067016.V333032.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 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users participate in activities that meet their individual styles and interests. The staff support the service users’ to take part in community events. The service users are supported to maintain contact with family and friends. This service provides balanced and varied meals. EVIDENCE: The service is able to provide additional in-house activities. These include theme days and nights. The home had organised a Welsh night over the weekend due to some of the service user’s interests in rugby. Other activities on the homes activities programme are often planned and structured and 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 12 include; the hot tub, and jigsaw puzzles, there is also a dark room with ultraviolet items to provide sensory stimulation. Many of the service users become involved in pampering sessions and arts and crafts. The home is located close to local amenities to include shops parks and stores. The service users are able to walk in to Cheltenham. Additionally as being part of the community service users frequently use the local hairdressers. The service users are known within the community and the staff team additionally assist with taking the service users to familiar places that adds to maintaining routines and consistency. The menus in the home are pictorial and contain a list of ideas that the service users can choose from. The home provides a well a balanced and varied range of foodstuffs which is based on a rolling weekly menu. 97a Shurdington Road DS0000067016.V333032.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, & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have their support in the manner to which they prefer and the staff team are responsive to their preferences. The emotional and physical health needs are met with support from a flexible team. The service has an effective medication procedure that minimise error. EVIDENCE: The manner in which support is provided is of significance to service users in the care home. The findings in this service, is one of flexibility, consistency and responsiveness. This was demonstrated via, the flexible manner in which the staff team dealt with the service users. For instance, the service users were independent and choose where they wished to sit, or join a meeting that was taking place at the time of the inspection. This additionally showed the staff responsiveness in which there was instant support if a service user had experienced difficulty in finding a seat for instance. The staff team are stable (refer to the staffing section for more details). The service users have complex 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 14 needs and also have difficulty with communication. The service has strong links with other health professionals that provide guidance on how to deal with complex health issues. For instance, some of the service users may have difficulty with their swallowing reflex. The health professionals assist in providing assistance on how to enable service users to maintain their daily life and routines in a safe manner. The delivery of personal care is also individual and flexible which is also combined with the person-centred package that Brandon Trust has introduced into this service. The approach of the staff team additionally coincided with comments made from the relatives who were visiting that day. Such comments include “ my relative is well looked after here we happy with her being here.” “ Flexible visitation, as we are coming to see someone in their own home.” The selected care plans demonstrate that the service users have regular access to other health care professionals. Service users have health action plans that outline the service user’s needs for example; service users can attend specialised clinics with support. The service additionally has good working partnership with the local health surgery. Health action plans are regularly reviewed. The service has an efficient medication procedure. The staff team are qualified to administer medication according to the home’s procedure and policy. Selected medication records were complete and were also examined for inaccuracies and omissions none were detected. There was clear evidence that the service has effective links with other professionals this is visible and assistance is regularly provided. 97a Shurdington Road DS0000067016.V333032.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 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a complaints procedure that protects the service user’s rights. The service users are protected from issues of abuse. EVIDENCE: This service has an open culture. This was evident during a discussion with the relatives on the day of inspection. The relatives comment that “ they had no concerns/complaints and were happy with the care provided.” The service has a complaints procedure that is clearly written and tends to communicate with the service users and relatives regularly. The manager had commented that the communication links between the relatives’ and the service is good and will deal with any matters arising instantly. No complaints have been voiced thus far. The home’s policy of openness extended to dealing with abuse type issues. The manager was able to plan and arrange an open team day in which the topic for discussion was on issues of abuse. Staff working in the home are trained in safeguarding adults. Many of the staff team are also covering this topic in their LADF programme of learning. The relative additionally commented, “ Staff do interact with the service users.” This can be seen as good practice as this ensures that communication and interaction is open and receptive and any changes in behaviour will be monitored and dealt with rapidly. A discussion with a member of staff additionally confirmed that the use of body language as a means of communication was also useful and enabled staff to provide appropriate care. 97a Shurdington Road DS0000067016.V333032.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 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The environment is clean and homely which provides accommodation for the service users. EVIDENCE: The physical design of the home is a large detached bungalow. It is large enough to enable the service users’ to live in a well-maintained and comfortable environment. There are four bedrooms and an additional bedroom has an en-suite facilities. The communal areas consist of lounge and diner and an additional dinner and conservatory with access to the garden. The laundry room is organised and clean. The home has access to a minibus that is suitable for wheelchair users. Advanced Housing who maintains the upkeep and repairs of the home manages the property. The bedrooms are personalised and fixtures and fittings are of good quality. The bathrooms are fitted with the appropriate aids and adaptations to meet 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 17 the complex needs of the service users. At the time of inspection the home was clean no offensive smells were detected. The manager also commented that the boiler had broken down and attempted to contact Advance housing on several occasions without any success. Advanced housing must ensure that items, which are considered to be vital such as hot water, are dealt with rapidly which would maintain the service users quality of life. 97a Shurdington Road DS0000067016.V333032.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 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The staff team in this service are trained and skilled in the task they perform. The service users individualised needs are met by appropriately trained staff. The service users are supported by a competent and qualified staff team EVIDENCE: The staff team has the skills to communicate effectively with the service users this was evident during the inspection. The staff team are small but stable, long-standing core of staff that provides flexible and consistent care. The service ensures that all staff are in receipt of the relevant training, which meet the positive outcomes for the service users. This was evident as certificates were seen which support that staff training is ongoing. During a discussion with a staff member they commented “ management is very supportive of training which additionally improves my confidence as a carer.” Data taken from the monthly visit reports additionally state that the training of two staff members is currently participating in an induction day for National 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 19 Vocational Qualification level four (NVQ4). Additional members of staff are commencing their NVQ3 this summer of 2007. The registered manager is also commencing the Person Centred Planning (PCP) facilitators’ course. It would appear that the staff team are well qualified which has positive benefits for the service users and ensures that the service provides a high level of care. . The service appears to have a good recruitment and selection procedures there has been no new employees at this service since the last inspection. Newly recruited staff commented on the enjoyable challenges the service has to offer and is commencing in a “course of sign language.” Additionally the relative commented that “ the staff seem to care more here and will bend-over backwards to help.” Although the standard for staff supervision was not assessed, supervision notes were seen during the inspection that confirms that supervision sessions take place on a regular basis of every three months. This is good practice. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 20 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 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users’ benefit from a home that is well managed. The home must review its monthly visits reports and adopt a more consistent way of sharing the information with the regulatory body. The service users live in a home that has maintained its health and safety standards. EVIDENCE: The registered manager is a qualified learning disabilities nurse with several years experience and is competent to manage the home. The ethos and leadership of this service is one of inclusiveness and openness that is of 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 21 benefit to the service users. The comments from the relatives are that “the staff are always willing to help you.” The staff members comment “management is approachable.” The manager appears to have a clear understanding of the key principles and main focus of the service and supervise that the care provision is provided accordingly. For instance the manager was able to describe that the service users needs were diverse and very individualised. The ability to provide choice to complex service users is a good achievement. The relatives are content with the service provision that would suggest that the service functions at a good level and the standard of care is at a good level. The home’s policies and procedures are a little outdated as it still carries the old provider details. However much of the practices form the functioning of the home such as the common sense guidelines which are based on the organisational values and priorities still exist and appears to work within the home. The home additionally is transparent and open. The manager was able to provide the documents on request and able to discuss a number of issues. The service is undergoing a self-monitoring system with the provider Brandon Trust that the home is likely to adopt. This will be monitored at the next inspection. The manager understands that it is important to self audit the service in order to improve and maintain good standards of care. The home has a consistent record of health and safety checks that regularly occur in the home. The manager additionally keeps an account of what needs to be completed and regularly supervises that the health and safety checks have been completed. The manager is also aware that the night staff must be included in any training and fire drills that occur in the home this would maintain continuity and consistency in the home and among the staff team of the day and night shifts. The home must additionally ensure that the monthly visits are regular and that the monthly reports are maintained in the home. It was noted and discussed with the manager that the monthly visit reports were inconsistent. In light of recent changes it is important that the monthly reports are produced and retained. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 22 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 X 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 3 3 X 3 X 2 X X 3 X 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 23 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 YA1 Regulation 4 (1 a, b, c) Requirement Timescale for action 20/06/07 2. YA43 26 (1,) The registered person shall compile in relation to the care home an updated written statement of purpose that shall consist of the main matters listed in Schedule 1. Monthly visits must be conducted 13/03/07 by the registered provider in accordance with this regulation. 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 YA40 Good Practice Recommendations The registered manager shall update the homes policies and procedures to bring documents more up to date with the change of provider. 97a Shurdington Road DS0000067016.V333032.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Gloucester Office Unit 1210 Lansdowne Court Gloucester Business Park Brockworth Gloucester, GL3 4AB 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 97a Shurdington Road DS0000067016.V333032.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!