Inspection on 09/11/06 for Bath Road (4)

This inspection was carried out on 9th November 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Bath Road (4) 05/11/08

Bath Road (4) 12/07/05

Bath Road (4) 18/01/05

Bath Road (4) 12/08/04

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 Bath Road (4) 4 Bath Road Bradford-on-Avon Wiltshire BA15 1SP Lead Inspector Ms Sally Walker Announced Inspection 9 November 2006 9:45 th Bath Road (4) DS0000028183.V311154.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 Bath Road (4) DS0000028183.V311154.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. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Bath Road (4) Address 4 Bath Road Bradford-on-Avon Wiltshire BA15 1SP 01225 864280 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) Mrs Sheila Mary Galley Mrs Sheila Mary Galley Care Home 1 Category(ies) of Learning disability (1) registration, with number of places Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 12th July 2005 Brief Description of the Service: Mrs Galley has been providing care to the resident in her own home since 1979. Having brought them up, the resident is considered part of the family. They have their own single bedroom. Mrs Galley supports the resident to access two different day services and some regular periods of respite care in another care home. The resident joins in with all the family social activities. Mrs Galley does not intend to offer care to any other residents. The fee for the service is £536.00 a week. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was arranged with Mrs Galley as she had not been at home when the inspector visited unannounced. The inspection took place between 9:45am and 12:45pm. The inspector met with the resident before they went to their day service. The care records, medication records and financial records were inspected. A tour was made of the communal space and resident’s bedroom. The social worker reported that there were no concerns with the home and that Mrs Galley provides very good support to the resident. The GP reported that they had no concerns about the quality of care the resident receives. They said the resident appeared to be looked after very well indeed. 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. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 6 The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Bath Road (4) DS0000028183.V311154.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 Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): X These standards are not applicable as Mrs Galley does not intend to provide a service to anyone else. EVIDENCE: Mrs Galley only provides care and support to one resident. Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The resident now has a plan of care specific to the home. Decision-making is encouraged on a limited basis but major decisions would be made in conjunction with the resident’s social worker. Mrs Galley is aware of any potential risk to the resident’s safety. EVIDENCE: The requirement that the resident’s care needs specific to when they are at the home must be included in the care plan had been actioned. Mrs Galley no longer relies on the day services or respite service to provide the care plan. The care plan shows how Mrs Galley supports the resident with personal care, meals and nutrition, communication and their activities. The resident was able to make some limited decisions on a day-to-day basis. However Mrs Galley was in regular contact with the resident’s care manager so other decisions would be discussed with them. Risk assessments were in place for activities that the resident was involved in whilst at the home. Mrs Galley was advised to record details of whether the resident had time alone in the bath for privacy in the bathing risk assessment. Mrs Galley had carried out her own risk assessment of the new stair lift pending that to be produced by the occupational therapist. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 10 Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. The resident attends 2 different day services and benefits from being considered one of Mrs Galley’s family. The resident was well known in the local community and was involved in local events. The resident’s rights, privacy and dignity were respected by Mrs Galley and her family. A good range of nutritious meals were provided according to the resident’s taste. EVIDENCE: The resident got up later at the weekend when they were not attending their day services. The resident was involved in a drama group through one of their day services and gave many local public performances including a local theatre. Mrs Galley said that the resident was particularly interested in music and drumming. They would watch the television music channels or listen to their music system in their room. They had drumming classes at one of their day services. The resident went to 2 different day services and as Mrs Galley drove them each day she would talk to staff about the resident’s needs. One of the day services was aiming to take the resident swimming which they had enjoyed in the past. They also went on various trips to local sites with this day service. Mrs Galley said she was waiting to be invited to one of the day Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 12 services’ reviews. The resident had regular periods of respite care throughout the year. At the weekends Mrs Galley either took the resident to local events, to see different members of her family or out shopping locally. They also went to local shows, carnivals or to family celebrations. Mrs Galley said that the resident was well known in the town and people would always stop for a chat. She said her grandchildren were fond of the resident and regularly came to visit them. She said the resident was considered to be part of the family. The resident had their own car in which Mrs Galley drove them to their day services and respite service. Mrs Galley said she was considering fitting a lift to the car so that it was easier for the resident to get into. She showed the inspector some examples. Mrs Galley was insistent that the resident had good quality clothing and were always well presented. The resident was well groomed and their clothing reflected the tastes of a younger person who liked fashionable clothing. The resident regularly had their hair cut in a fashionable style. Mrs Galley kept a record of all the meals served to the resident. She said they had a good appetite and over the years she had got to know what they liked and disliked. This was recorded in their care plan. Increasingly, due to the resident’s improved good health, Mrs Galley had reduced the amount of liquidised or mashed food given in agreement with the resident’s consultant and the resident enjoyed their food. Mrs Galley said she was going to obtain the menus for one of the day services so that she did not duplicate meals. She already had the menu for the other day service. Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Mrs Galley has been providing care and support to the resident for more than 26 years. She is very familiar with their all their care needs and how they are to be met. Mrs Galley ensures that the resident has good access to healthcare professionals. Mrs Galley administers the resident’s medication. EVIDENCE: A record of the resident’s health care needs was kept in the care plan including current medication and previous medical conditions. There was a profile of the resident’s previous history, significant contacts and communication needs. Mrs Galley regularly took the resident to the dentist. Over the years Mrs Galley has built up an understanding of how the resident communicates with her. It was clear from observation that the resident understood Mrs Galley when she spoke to them. She said she knew from body language, gestures, verbalisations and facial expressions when the resident was in pain, did not like something or wanted to go to bed. The resident was able to communicate what they wanted or could refuse something. Mrs Galley said she had good access to the resident’s GP and was able to discuss any health concerns with them directly. The daily report, in the form of a diary, gave a good picture of how the care and support was being provided including records of activities, moods and general wellbeing. The resident was not able to administer their own medication. Mrs Galley kept the medication in a locked facility with Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 14 records of all administrations. Any homely remedies would only be given in consultation with the GP. The GP had given written permission for a tablet to be administered on top of cereals with the resident’s breakfast as they could not take tablets without a medium to help them swallow. Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Mrs Galley and the care manager advocate for the resident. Systems were in place to ensure that any concerns, allegations or complaints were taken seriously. Mrs Galley was familiar with the local vulnerable adults reporting procedure. EVIDENCE: Mrs Galley worked to the complaints procedure of the placing authority. She had regular contact with the resident’s care manager, their day services and respite service. She said she hoped that they would discuss any concerns directly with her. She said she had not received any complaints. Mrs Galley encouraged the resident to save in their own named interest bearing account with a record of all purchases and receipts. Mrs Galley said the social worker regularly audited these arrangements. Mrs Galley was aware of the local policy on the protection of Vulnerable Adults and had a copy of the procedure. Bath Road (4) DS0000028183.V311154.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 29 & 30 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Mrs Galley provides a very clean, comfortable and well-maintained environment in what is her family home. Mrs Galley has sought further equipment so that the environment is more accessible for the resident. EVIDENCE: The resident has their own bedroom adjacent to the bathroom. The bedroom was warm, clean and comfortable and brightly decorated. Mrs Galley was keen to explain how she ensured that the resident was comfortable in their bedroom with padded headboard, new bedding and all their certificates and photographs displayed so they could easily see them. Mrs Galley’s bedroom was adjacent to the resident’s and she said she would hear if the resident needed assistance during the night. Aids were in place for the resident to relax or get about with support, for example, a specially adapted armchair or wheelchair. A stair lift had been fitted following an occupational therapist’s assessment. The occupational therapist was due to come back and write a risk assessment for the lift. However in the meantime Mrs Galley had written her own assessment of the risks of how she managed assisting the resident to use the lift. Mrs Galley had had a new shower fitted and intended that the bathroom would be refitted soon. The home was cleaned to a high standard and it was clear that Mrs Galley took pride in ensuring the resident’s clothing was well laundered. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 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 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): X These standards are not applicable as Mrs Galley employs no staff. EVIDENCE: Mrs Galley provides the care and support to the resident and no staff are employed. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 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 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 & 42 The Quality in this outcome area is good. This judgement has been made from evidence gathered both during and before the visit to this service. Mrs Galley has provided care and support to the resident in her own home since they were 6 months old. She has a very good understanding of the resident’s care needs. The resident benefits from her extensive experience and knowledge of providing care and support to younger adults in care settings and in hospital. Mrs Galley is aware of the risks to the health and safety of the resident. EVIDENCE: Mrs Galley has had over 29 years experience of caring for people with learning disabilities; in hospital, care homes and in education. Mrs Galley undertakes a small number of relief shifts in a nearby care home in which she used to work part time. This work does not compromise the care of the resident as it is during the day when they are at day services. Mrs Galley said she did some of the training programme provided by this home to keep herself up to date with current practice. Recent training had been fire safety, first aid and food hygiene. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 19 Mrs Galley kept a record of her tests of the domestic fire alarms fitted with advice from the Fire and Rescue Authority. She has assessed the risks to the resident with regard to their care and the environment. Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 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 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 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 N/A 33 X 34 N/A 35 N/A 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 3 X X 3 X Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 21 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Bath Road (4) DS0000028183.V311154.R01.S.doc Version 5.2 Page 22 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. 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