Inspection on 11/07/05 for Addington Close (12)

This inspection was carried out on 11th July 2005.

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 but made no statutory requirements on the home.

Other inspections for this house

Addington Close (12) 07/05/09

Addington Close (12) 10/05/07

Addington Close (12) 11/05/06

Addington Close (12) 05/12/05

Addington Close (12) 22/11/04

Addington Close (12) 21/04/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Addington Close (12) 12 Addington Close Devizes Wiltshire SN10 5BE Lead Inspector Malcolm Kippax Announced 11 July 2005 th 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 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 Stationary 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. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Addington Close (12) Address 12 Addington Close Devizes Wiltshire SN10 5BE 01380 720001 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Ordinary Life Project Association Mrs Helen Patricia Morgan Care Home 3 Category(ies) of LD Learning Disability registration, with number of places Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No more than 3 service users with learning disabilities at any one time Date of last inspection 22 November 2004 Brief Description of the Service: 12 Addington Close is one of a number of homes managed by the Ordinary Life Project Association (OLPA). 12 Addington Close is a bungalow in a residential area of Devizes. The home fits in well with the neighbouring properties. The accommodation is domestic in style and consists of a living room, a dining room, a kitchen and three single bedrooms. Service users receive support from a manager and small team of permananent staff. Agency and relief staff also regularly work in the home. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged with the home’s manager at short notice. The inspection started at midday and took place over five hours. The three service users, the manager and a staff member were spoken with. There had been no changes in occupancy during the last year. Two service users have lived together since 1995 and the third person moved into the home approximately two years ago. The accommodation was looked at and a selection of the home’s records was examined. What the service does well: What has improved since the last inspection? What they could do better: Service users are encouraged to have personal goals although the staffing arrangements make it difficult for service users to receive the consistent and one to one support that is needed to achieve these. The aim should be to have a permanent staff team that can provide support for service users without the need for agency and relief staff to be used on a regular basis. There is a lack of clarity about a policy for the provision of personal care. Service users need to have better information about making a complaint and some information needs to be made more accessible. At an organisational level a more pro-active approach is needed to improvement and to annual development in areas that will be of benefit to service users. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 standard(s) These standards were not assessed on this occasion. EVIDENCE: Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 standard(s) 6, 7 and 8 Service users benefit from the information staff members have about their individual needs. Service users are asked about their personal goals, which are well reflected in individual plans The service users are listened to by staff and encouraged to take an active role in the home EVIDENCE: Each service user had an individual plan, which described in good detail their care needs and preferred routines. The plans had been written during 2004 and the initial information was well presented. Some changes in the service users’ care needs had been reported although the plans did not include a review section. Service users said that they did not have their own copy of the plan. The care records also contained a ‘Shared Action Plan’ that included details of the service users’ personal goals. The goals were specific and individual. In conversation with the service users it was evident that the goals reflect their interests and aspirations. The staff member spoken with said that, in her role Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 10 as keyworker, she had supported one of the service users with preparing the action plan and writing the goals. Staff members monitor the service users’ progress in achieving the goals. There was variation in the recording of progress and some updating was required. Other reports gave an up to date view of what the service users are doing. The minutes of recent ‘tenants’ meetings were looked at. These showed that service users meet together on a regular basis and can raise ideas about what they want to do and make decisions about matters affecting them. The minutes were detailed and an ‘action’ section showed who would be responsible for ensuring that decisions are implemented. A staff member attends the meetings and service users said that they are a useful time for discussing things. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 standard(s) 13, 15, 16 and 17 Service users are encouraged to take part in community activities although this is limited by the staff support that is available. Service users have individual lifestyles, which are respected by staff. Service users enjoy the meals. They are well consulted about the menus and what they want to do. EVIDENCE: One service user had been out all day and returned at about 4 pm. He had a varied week, which included college and part-time work. The service user said that he enjoyed some regular evening activities and was able to do these independently. The other service users had home-based days, which for one service user included a supermarket shopping trip with a member of staff. One service user, speaking about community activities, would like to have more one-to one time with staff and to be able to do more things outside the home. A number of the service users’ personal goals concerned new activities. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 12 One service user spoke about contact with family members. Information about family backgrounds and contacts was available on the service users’ personal files. The staff member said that this was an area that the keyworkers helped service users with. The minutes of one of the ‘tenants’ meetings showed that letter writing to relatives has been discussed and that service users receive support from staff with this. Two service users had lunch together in the dining room. This was an informal meal and the service users had large plates of different salad and buffet type foods. Service users said that they enjoyed the food and could choose the meals they like. Menus are kept showing what each service user has eaten. The staff member and manager said that there was encouragement with healthy eating. It was evident from discussion during the meal that this was given in a friendly and informed way. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 standard(s) 18 and 19 The service users’ care needs are well met within the home although there is a lack of clarity concerning a policy for the provision of personal care. Service users benefit from the support that they receive with health care. EVIDENCE: Each service user has their own room where personal care can take place in private. The bathroom and toilet are close by. There was no policy concerning gender and the provision of personal care, although the manager said that some unwritten guidelines concerning good practice are followed. The health needs of service users were reported in their individual files. Service users have had support from staff to maintain specialist appointments. The records showed that service users have seen a range of healthcare professionals, including optician, chiropodist, and occupational therapist. Visits to GPs were well reported and the records indicated good monitoring of the service users’ on-going healthcare needs. The minutes of staff meetings showed that the service users’ health and wellbeing is discussed on a regular basis. One service user in particular has received close support and attention with healthcare. Service users said that they received the support that they need and got on well with staff. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 14 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 standard(s) 22 Service users are encouraged to raise any concerns with the home but need to have better information about making a complaint. EVIDENCE: Each of the service users’ personal files contained a copy of the OLPA complaints procedure. Service users said they were not familiar with this and did not have a copy in their rooms. The service user’s guides, with include a copy of the complaints procedure, are not readily accessible to service users. The manager said that she would like to produce the service user’s guides in a more personal and suitable format for each service user. The minutes of the ‘tenants’ meetings showed that the service users’ views are listened to and that day to day concerns can be raised and followed up. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 15 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 standard(s) 24, 26 and 28 The accommodation is meeting the service users’ needs. Service users’ benefit from a homely and domestic environment although a more planned approach to refurbishment would be beneficial. EVIDENCE: The home is situated in a quiet cul-de-sac and the property is in keeping with the local area. The accommodation was clean, comfortable and well furnished. An occupational therapist has advised about specialist equipment, which is provided in the bathroom for one service user. The service users’ own rooms vary in size and outlook. One room in particular has very limited space for socialising. The home was registered before current standards came into force. Service users said that they are happy with their rooms and it was seen that they have made good use of the space and are able to decorate and personalise the rooms as they wish. Service users have bought much of their own furniture. A hoist bar in one service user’s room was no longer in use and the manager said that this could be removed. A programme for the fitting of radiator covers is being undertaken. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 16 The facilities for staff are not ideal and staff have to sleep in the communal lounge once service users have gone to bed. This is a shortcoming in meeting the standard although without major alteration to the property a separate area would be difficult to provide. The lounge itself is comfortably furnished and the staff facility is not too intrusive. Service users made good use of the lounge during the visit. Service users also benefit from a well maintained and good sized garden with a patio area and barbeque. The manager said that the lounge was shortly to undergo redecoration and some updating of style. The fitted units in the kitchen are showing signs of wear and tear. The floor covering had recently been replaced although there are no other plans for the kitchen. The manager said that there was no planned programme of refurbishment. This is recommended as a way of ensuring that larger works involving capital expenditure are completed in a timely manner. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 Service users appreciate the support that they receive. Service users would benefit from a more systematic approach to determining staffing levels. EVIDENCE: The staff member spoken with said that staff members usually work by themselves. The staff member who works in the evening provides sleep-in cover and then works in the morning to support service users. A written rota is planned in advance. Two staff members work together at specific times, for example when a service user needs support with an appointment outside the home. One of the service users spoken with would like to have more individual time with staff and to go out more. The manager said that there was no means in place for calculating staffing levels based on the needs and personal goals of the service users. Agency and relief staff are used on a regular basis. Some permanent staff members have reduced their weekly hours and there are insufficient permanent staff members to meet the service users’ needs. The manager said that one new permanent staff member had been recruited and would shortly be starting work. However, agency and relief staff will continue to be needed. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 and 39 Service users enjoy an open and informal atmosphere and benefit from the management approach within the home. Service users do not benefit from the organisational approach, which does not promote improvement or encourage annual development EVIDENCE: The home has an experienced manager who has a specialist nurse background and is suitably qualified to be in the role. The manager has completed the Registered Managers Award and is near to completing NVQ level 4 in Care. 12 Addington Close presents itself as a well managed home which provides service users with a supportive environment within the resources available. The relationships between service users, manager and staff member were seen to be friendly and positive. Service users were talked about in a respectful manner. Individual conversations with service users showed a thoughtful and personal approach to what was talked about in the presence of others. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 19 The records and minutes of staff and ‘tenants’ meetings showed a management approach that is appropriately focused on the service users’ needs. Personal goals for service users are generated through ‘Shared Action Planning’. The staff and manager are keen to promote further opportunities for service users although this is limited by the staff support that is available. Some quality assurance type measures are in place, most evidently through the ‘tenants’ meetings and individual review meetings. Other measures have taken place at an organisational level although these have not been developed into an annual development plan. There was no strategy for improvement or system of quality assurance based on a cycle of planning, action and review. Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x 2 x x Standard No 11 12 13 14 15 16 17 x x 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Addington Close (12) Score 2 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 2 x x x x D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 21 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 22 Regulation 22 Requirement Each service user must be given a copy of the homes complaints procedure in an appropriate format NA Timescale for action BY 12/08/05 2. 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. 2. 3. Refer to Standard 6 6 8 Good Practice Recommendations That the service users progress in meeting their Shared Action Plan goals is regularly monitored and recorded That a review section is added to the care plan forms That a statement on personal care is produced to include the organisations policy on gender and personal care and to provide details of any limitations and restrictions that may apply in the provision of personal care That the hoist ceiling track in the service users room is removed That a programme of refurbishment is produced for the home That an appropriate system is used for calculating staffing levels based on the needs and personal goals of the service users Permanent staff members should be appointed in sufficent numbers to support service users without the need for the D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 22 4. 5. 6. 7. 24 24 33 33 Addington Close (12) 8. 9. 39 39 regular use of agency and relief staff That an annual development plan is produced for the home That a system of quality assurance, based on a cycle of planning, action and review, is produced Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 23 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham SN 15 2BB 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 Addington Close (12) D51_D01_S28256_ADDINGTON(12)_v214823_110705Stage4.doc Version 1.40 Page 24 - 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!