Inspection on 17/11/05 for Arundel Close (1)

This inspection was carried out on 17th November 2005.

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

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

Other inspections for this house

Arundel Close (1) 27/02/09

Arundel Close (1) 13/02/07

Arundel Close (1) 27/07/05

Arundel Close (1) 21/02/05

Arundel Close (1) 01/10/04

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 Arundel Close (1) Chippenham Wiltshire SN14 0PR Lead Inspector Malcolm Kippax Unannounced Inspection 17th November 2005 12:30 Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Arundel Close (1) Address Chippenham Wiltshire SN14 0PR 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) 01249 651112 01249 765520 www.unitedresponse.org.uk United Response Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: 1 Arundel Close is one of a number of homes that are run by the national charity, United Response. The home is a detached property in a residential area of Chippenham. 1 Arundel Close fits in well with the neighbouring properties. The accommodation is domestic in style and includes a lounge, a dining room, a recreation room and four single bedrooms. Service users receive support from a manager and a permanent staff team. Relief staff members also regularly work in the home. A keyworker system is in operation. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 12.30 pm and lasted for 4½ hours. The four service users, the acting manager and staff members were met with. Only limited conversation was possible with the service users. Three service users were having home-based days and one service user returned later in the afternoon from his day activities. Records were examined, including staffing, health & safety, quality assurance and examples of the service users’ care and personal records. The home was without a registered manager following the departure of the previous manager earlier in the year. Mr T. Smith, a senior support worker and a former manager with United Response, was managing the home until a new manager is in post. What the service does well: What has improved since the last inspection? What they could do better: Quality assurance should focus more on the views of service users and on obtaining feedback from interested parties outside the home. The arrangements for quality assurance also need to include the production of an action / annual development plan. This should reflect the feedback that has been received and identify areas for improvement. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 did not apply at this time. There were no vacancies and the current service users have lived together for a number of years. EVIDENCE: Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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): 7 and 9 Service users are supported with making decisions about their lives and what they want to do. They benefit from the approach that is taken to assessing risk. (Standard 6 was inspected and almost met at the last inspection). EVIDENCE: Examples of records from the four service users’ personal files were looked at. Review meetings are being held and the minutes showed that the service users’ wishes and views are being discussed. The meetings cover such areas as ‘family and friends’ and ‘health and well-being’. The service users would find it difficult to contribute directly in a formal meeting setting. Review notes had been prepared in advance of the meetings by the key worker, in conjunction with the service user. This enables service users to express their views in a more appropriate way. Review meetings had recently been held. The files included records of risk assessments that covered a range of activities and facilities. These showed that good attention is being given to support service users with activities and pastimes that may involve a degree of risk. Although some were of a general nature, e.g. bathing and window openings, Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 10 others were specific to an individual and covered things that they liked to do, e.g. going to the shops and having a Centre Parc holiday. Many of the risk assessments had been updated in August 2005. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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): 13, 15 and 16 Service users have some regular activities in the community and further opportunities will be beneficial. A local shop is well used. Service users receive support from staff with their family relationships. One service user has a well established social network outside the home. Service users are encouraged to treat the home as their own. (Standards 12 and 17 were inspected and met at the last inspection). EVIDENCE: ‘Weekly Activity Plans’ were kept in the service users’ records. The weekly programmes involve some activities outside the home. For two service users this included attending a local resource centre. Changes in day centre provision meant that two other service users now had fewer planned activities. The staff team were filling these gaps by providing support with more home based pastimes and community activities, such as swimming. The acting manager said that two new activity sessions had recently been arranged for one service user. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 12 A ‘Monthly Activities’ sheet was seen on one service user’s file. This is a way of helping to ensure that service users regularly participate in a range of community activities throughout the month. However the sheet did not give a complete and up to date record and its usefulness was reduced. During the inspection, one service user went out to a convenience store, which is around the corner from the home. He enjoyed this independence and the contact with other people. Staff members could easily check on his progress and on any unexpected occurrences. Other service users use the shop with support from staff. Staff and service users spoke about the visits that are made to family members. One service user stays with parents every other weekend. The service users’ records included an, ‘About Me’ section, which states the service users’ important personal contacts and relationships. These are also discussed at review meetings and recorded under a ‘Family and Friends’ section. One service user said that he had friends at a local rugby club where he was made to feel welcome. He was well particularly well supported with this by the home’s acting manager. Opportunities for other service users and their capacity to develop friendships outside the home appeared to be more limited. The service users’ home-based days are a time when they can do some regular domestic and personal tasks with support from staff. It was evident during the inspection that service users are able to participate, within their abilities, in the everyday routines such as making drinks and responding to callers with support from staff. There was also encouragement for people take small responsibilities, such as putting clothes away in their rooms before moving on to something else that they wanted to do. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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 Service users benefit from the support that they receive from the staff team. The staff team have worked hard to help one service user following a recent accident. (Standards 19 and 20 were inspected at the last inspection. Standard 20 was not met and Standard 19 was almost met). EVIDENCE: Standards 19 and 20 were not inspected on this occasion, other than to check that the requirements identified at the previous inspection had been met. Information was available to staff in the form of general guidelines about what to do at particular times of day, e.g. when covering a sleep-in duty or during the early shift. More personal information was included on the service users’ files in the form of an ‘Intimate and Personal Support’ assessment form and a ‘Medical Profile’. This information had been updated in September 2005 and provided staff with individual guidelines for how to support service users. Visits to GPs and healthcare professionals were recorded on other forms. Visits had recently been made for flu vaccinations. Epilepsy and diabetes profiles have been updated since the last inspection. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 14 One service user has suffered a broken leg since the last inspection. A rota was in place for supporting the service user while in hospital and it was evident from talking to staff that they have responded positively and flexibly to caring for the service user in these circumstances. This has meant some change to the usual routines in the home and to the accommodation for the duration of the service user’s rehabilitation. The home had received a letter from the service user’s parents in appreciation of the efforts that they have made. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Service users are listened to although are dependant on others for raising any formal concerns. Staff members receive guidance about abuse, which helps to protect service users. EVIDENCE: The acting manager said that no complaints had been received. United Response has produced an organisational complaints procedure for the services they run. This has been adapted and simplified locally and given to service users in the form of a laminated card. The acting manager recognises that further work is needed in order to produce a more accessible complaints procedure, although service users would find it difficult to instigate any form of formal complaint proceedings. The views of service users and others are sought at review meetings. It was recommended to the acting manager that these and other, less formal occasions, are seen as an opportunity to assess the service users’ satisfaction and the need for any concerns to be raised on their behalf. A member of staff said that training in abuse had been provided through United Response and that she was aware of the ‘No Secrets’ guidance. The home’s policy and procedures file contained information on the prevention and reporting of abuse. This had been produced as a new policy in 2004. The home receives updated policies and procedures on a regular basis through United Response, together with an accompanying sheet for staff to sign to confirm that they have read the information. The sheet that came with the Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 16 abuse policy could not be located during the inspection and the acting manager confirmed that he would follow up its whereabouts. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 17 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): 30 The accommodation is kept clean and tidy. (Standard 24 was inspected and met at the last inspection). EVIDENCE: The home looked clean at the time of the inspection. A staff member said that cleaning is part of the support worker’s role. She was familiar with the C.O.S.H.H. arrangements and said that product information is recorded when it comes into the home. There was a locked cupboard for the C.O.S.H.H. materials. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Service users benefit from the training and guidance that staff members receive. The recruitment arrangements help to protect service users from unsuitable staff. (Standards 33 and 36 were inspected and met at the last inspection. Standard 33 was met and standard 36 was almost met). EVIDENCE: Individual training records were included in the staff members’ employment files. A staff member who started in August 2005 was undertaking LDAF foundation and had participated in a range of training events during September and October. These included moving and handling, medication, challenging behaviour, ‘the way we work’, first aid, prevention of harm and health & safety. Some training had also been undertaken in areas relating to the needs of service users, such as diabetes. Epilepsy had not been covered and it is recommended that an appropriate training event is shortly arranged. Another staff member said that information about relevant courses is emailed to the home from the local United Response office. She had started NVQ at level 3, after achieving level 2. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 19 A staff member said that the home had been let down by people who had been through the recruitment process for a support worker, only to decline the offer of appointment at a later date. The recruitment records for the most recently appointed staff member showed that the appropriate checks and references are being followed up. There was evidence of proof of identity, CRB check (with POVA) and written references. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Service users have benefited from the approach of the acting manager. An organisational audit is in place. However this is lacking as a system for quality assurance and annual development, which will be of more direct benefit to service users. Appropriate arrangements are in place for maintaining health and safety in the home. (Standard 41 was inspected and almost met at the last inspection). EVIDENCE: The registered manager has left since the last inspection. At the time of this inspection the Commission had not received an application to register a new manager. The acting manager is a support worker who knows the service users well and has previous management experience with United Response. He is familiar Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 21 with the manager’s regulatory responsibilities and the Commission has been appropriately notified of certain events since the last inspection. There is an in-house audit system in which a United Response manager assesses standards during regular visits to the home. The acting manager said that there was no annual development or improvement plan in place. Parents have commented on their experience of the home and there are opportunities for service users to express their views. However these do not contribute to a system of quality assurance. The acting manager and staff team have responsibility for overviewing areas of health & safety. The home’s fire log book was up to date. There is a ‘Master Checklist’ for matters relating to health & safety. This shows the timescales for the completion of checks and servicing of various facilities and items of equipment. Daily checks included food hygiene, with several areas such as the home’s vehicle being checked on a weekly basis. In-house checks are recorded and there was evidence on file of servicing that has been carried out by outside contractors. A monthly hazard inspection had last been carried out on 5 November 2005. PAT electrical testing had taken place in December 2004. Accident and incident reports are being completed. There appears to be a low rate of accidents although some have had a significant impact on service users and staff. Risk assessments are recorded on an individual and a generic basis. Those relating to service users were included on their individual files. The need for further risk assessments was reviewed in August 2005. A risk assessment had been completed following a service user’s return from hospital (see Standard 18). This was discussed with the acting manager. An occupational therapist had also assessed a change in the sleeping accommodation and arrangements for this service user and advised on the use of certain aids and equipment. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X N/A X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Arundel Close (1) Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 3 X DS0000028238.V268550.R01.S.doc Version 5.0 Page 23 Are there any outstanding requirements from the last inspection? No 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 YA39 Regulation 24 Requirement A form of annual development / improvement plan must be produced, based on a review of the quality of care. This must include the contribution of service users and their representatives. Timescale for action 30/04/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA13 YA22 Good Practice Recommendations That the monthly activities sheets are consistently and fully completed in order to give an accurate record of the activities undertaken. That the written information and guidance about complaints includes a reference to the different ways and opportunities that service users may have to raise concerns and how these will be followed up. That epilepsy training is promptly arranged for staff members who have not already attended an appropriate course. That a statement on quality assurance is produced to show how this is implemented in the home and the timescale for DS0000028238.V268550.R01.S.doc Version 5.0 Page 24 3. 4. YA35 YA39 Arundel Close (1) the frequency and completion of the different components. Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 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 Arundel Close (1) DS0000028238.V268550.R01.S.doc Version 5.0 Page 26 - 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!