Inspection on 24/02/06 for Augusta Close (5 & 6)

This inspection was carried out on 24th February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Augusta Close (5 & 6) 04/07/07

Augusta Close (5 & 6) 21/11/06

Augusta Close (5 & 6) 15/05/06

Augusta Close (5 & 6) 28/09/05

Augusta Close (5 & 6) 02/02/05

Augusta Close (5 & 6) 17/08/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Augusta Close (5 & 6) Parnwell, Peterborough PE1 5NJ Lead Inspector Lesley Richardson Unannounced Inspection 24th February 2006 2:30 Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Augusta Close (5 & 6) Address Parnwell, Peterborough PE1 5NJ 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) 01733 890889 Mr Alan Atchison Mrs Deborah Evans Care Home 9 Category(ies) of Learning disability (9) registration, with number of places Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th September 2005 Brief Description of the Service: Augusta Close consists of 2 properties, situated on a residential estate on the north eastern edge of Peterborough. Both houses are two-storey, detached properties in the same road. They are owned by Mr Alan Atchison and provide care and support for up to 9 people with learning disability. 5 Augusta Close has 4 bedrooms and 6 Augusta Close has 5 bedrooms, both houses have a lounge/dining room, kitchen, bathrooms with shower and toilet and a separate toilet. The houses share access to a large back garden with patio and lawn. The houses are within walking distance of local shops, pubs, a post-office and public transport. Peterborough city centre is about 5 miles away and is easily accessed by public transport. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over 3 hours by two inspectors and was carried out as an unannounced inspection on 24th February 2006. It was the second inspection of this home for the 2005-2006 year. Two hours were spent examining records and documents and one hour was spent with service users and staff. A tour of the building was also undertaken during this time. The manager was present during some of the inspection. Seven people who live at the home and two of the staff on duty were spoken to during the inspection. Information from an additional visit undertaken on 11th January 2006 is included in this report. What the service does well: What has improved since the last inspection? The home has undergone extensive redecoration and renovation to make it a safe and comfortable place to live. There are still some small areas that need attention to make sure all areas are comfortable and homely. The home should start a programme of routine checks to identify maintenance items. This would stop the décor deteriorating and keep the home in a good state of repair. The home has started to arrange training for the staff, which makes sure that everyone living at the home can be cared for properly. A record of training that is needed and that has been given should be started. This would make sure all staff members get the proper training. Improvements have also been made to the recruitment and vetting procedures, and supervision of staff members. All staff now have the proper checks to make sure they are safe to work with vulnerable adults. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 6 A quality assurance survey has also begun and questionnaires have gone out to the people who live at the home so that they can give their opinion of the home they live in. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: These standards were not assessed on this occasion. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 There is no clear or consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet service users needs. EVIDENCE: The home has two files that provide information about how to care for service users. One file that contains mostly older reports and archived material, a folder that contains up to date information. The care records for three service users were looked at in detail. Care plans are written to advise staff members of how to meet service users needs and identify aims. Two service users care plans were written in 2003 and have not been updated since then. The other service user’s care plan was written one month after admission at the end of 2004 and has not been updated. Social service departments conduct reviews of care annually and each service user is present during this meeting. The care home then completes its own review of care, to which service users are not party. Not all issues identified in social service reviews are identified in the home’s own Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 10 review. Similarly not all goals and issues identified in care plans are discussed in review meetings. Examples of this are: Identified goals in one care plans are for increased independence in personal hygiene tasks and being able to self-medicate. Although these issues are mentioned in the review report there is nothing that identified progress, what action is being taken to address the issues, or if the goals remain relevant. Another care plan identifies issues such as the need for that service user to clean their bedroom and the lounge on particular days. The review does not identify these issues at all. Care records do not properly show how staff should care for people living at the home, because issues that may be identified do not have a plan that guides staff in what actions they need to take in order to meet that need. There are no risk assessments to show how service users are able to take responsible risk, although clearly risk is taken as some often travel independently, attend day services without accompaniment of staff, and cook and clean in the home. Similarly, care records do not identify instances where service users rights have been limited through the assessment process. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15, 16 and 17 The home has systems that ensure service users rights are respected and they are able to maintain appropriate relationships. EVIDENCE: Information is available in care records about who service users have familial and social relationships with. However, there is no information or plan in care plans or review reports that tells staff how to enable service users to maintain that contact or guide them if relationships break down. Service users said they are able to see who they wish. One service user was entertaining a friend in her bedroom during the inspection. Service users are able to lock their rooms when they are out of the house and have keys to the front door. They have access to both houses and it is only individual bedrooms that all service users are not able to access. The home has one service user whose dietary choice is vegetarian; she said she has a choice of meals and is able to cook what she wants. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 12 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): 20 The systems for the administration of medication must improve to ensure service users are not at risk. EVIDENCE: A requirement was made at eh last inspection that staff administer medication should receive appropriate training. However, there is no evidence that more than one staff member has received such training. The manager said she trains new staff members before they are able to administer medication to service users. This is the only training most staff members have received on medication and is not enough to ensure service user safety. Medication was being administered during this inspection. Medication was dispensed into disposable pots for three service users and then taken to the service users without reference to medication administration record charts. This is unsafe practice and was discussed with the manager at the time of the inspection. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 13 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): EVIDENCE: These standards were not assessed on this occasion. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The standard of décor within this home has improved presenting as a homely and comfortable environment for service users. Further improvement is required for this to remain so. EVIDENCE: There has been considerable renovation work on both houses and most areas of concern that were highlighted at the last inspection and the following visit to check compliance with requirements have been either repaired or replaced. However, there are still two areas that must be improved: the hole in the kitchen cupboard door and the cracked plaster and paint next to landing light switch, both in no. 6. The home was generally clean and tidy on the day of inspection, décor is domestic in appearance and service users are comfortable with the layout. There were no offensive odours. The home should complete a routine maintenance assessment and programme to ensure it remains in a good state of repair. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 15 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): 33, 34, 35 and 36 There has been some improvement in staff training opportunities, but further improvement is required for all staff to be able to meet the needs of service users. EVIDENCE: Staffing rotas were again looked at to verify whether changes have been made to improve recording. There have been no changes to the staffing rota, which does not give a clear indication of shift times being worked or which staff member is on duty overnight. Rotas were inspected during the compliance visit on 11th January 2006 regarding the lack of female staff during the day, thereby restricting one service user’s ability to perform personal care tasks. This occurred on three separate occasions, each in a different week. This has been discussed with the provider who has agreed to review the staff rota to ensure female service users are able to have assistance from a female member of staff during the day. Information supplied following the compliance visit shows the two staff files identified at the inspection on 30th September 2005 that did not have Criminal Record Bureau checks now have the appropriate checks on record. Similarly, the home has been able to show an improvement in staff training to ensure service users needs can be met. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 16 An extension to the timescale for action was granted at the compliance visit regarding a requirement made for all staff members to receive appropriate supervision. Although it was reported that staff supervision has been started, records were not available to inspect. This will be checked at the next inspection. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 17 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, 38, 39 and 42 There has been some improvement in the systems for service user consultation but as yet no evidence that service user views are acted upon within the home. EVIDENCE: Although the manager said she has resigned from the position at the last inspection, this had not been confirmed in writing to the Commission for Social Care Inspection until the 20th March 2006. The present manager will remain in post until 31st March 2006. Although there have been improvements there remains evidence that the management of the home is not effective in ensuring staff have adequate support and training. A quality assurance survey has been started with questionnaires now being returned by service users. A questionnaire is being developed for relatives and visitors to the home and for stakeholders in the community. A service user who has expressed an interest in the task now completes hot water temperature checks and fridge/freezer temperature checks. Although there was some discrepancy with recording the decimal point, it was clear hot Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 18 water checks are now within an acceptable range. Staff were advised of the need to ensure the service user has appropriate guidance and training to perform the task correctly. Training records indicate none of the staff members have had all of the mandatory health and safety training or updates. This must improve to ensure staff and service users are safe. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 19 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 X 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 X 23 X 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 X 33 2 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 1 1 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 1 x 2 2 3 X X 1 x Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? YES 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 15 Requirement Timescale for action 15/04/06 2 YA8 24(1), (3) 3 YA9 13(4)(b) 4 YA20 13(2) The registered person must prepare a written plan as to how the service user’s needs in respect of his health and welfare are to be met. The registered person must keep the service user’s plan under review. 15/04/06 The registered person must establish and maintain a system for reviewing and improving the quality of care provided at the care home. The system referred to must provide for consultation with service users and their representatives. (Previous timescale of 23/02/06 has not been met.) The registered person must 15/04/06 ensure that any activities in which service users participate are so far as reasonable practicable free from hazards to their safety. The registered person must 15/04/06 make arrangements for the recording, handling, safekeeping, safe administration and disposal of DS0000015142.V276548.R01.S.doc Version 5.1 Augusta Close (5 & 6) Page 21 5 YA42 medicines received into the care home. (Previous timescale of 30/11/05 has not been met.) 13(3)(4)(5), The registered person must 16 make suitable arrangements to prevent infection and the spread of infection at the care home, for the training of staff in first aid, and to provide a safe system for moving and handling service users. 31/03/06 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 3 4 5 Refer to Standard YA6 YA7 YA33 YA35 YA42 Good Practice Recommendations Service users care plans should be reviewed on a 6 monthly, or more frequent, basis. Instances when service users’ rights are limited should be recorded. Staffing rotas should clearly identify shift hours and which member of staff is working on each shift. A staff training programme should be developed to ensure all staff receive training appropriate to the work they are to perform. Any person within the home performing health and safety checks should be assessed to ensure they have the knowledge and competence to properly carry out the role. Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Augusta Close (5 & 6) DS0000015142.V276548.R01.S.doc Version 5.1 Page 23 - 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. 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