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Inspection on 28/10/05 for Bath Road, 85

Also see our care home review for Bath Road, 85 for more information

This inspection was carried out on 28th October 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home is comfortable and welcoming. Service users get a lot of help to choose food they like, and it is healthy. Staff make sure that service users` health is taken care of. Staff are well trained. All staff are able to communicate with service users using sign language.

What has improved since the last inspection?

Plans for how staff care for service users are kept more clearly. Staff are keeping full records of food provided. Service users` health records are being kept clearly. The registered provider has improved the building, by fitting a new kitchen and patio doors, and more changes are about to be made e.g. new carpets, redecoration.

What the care home could do better:

Plans for how staff care for service users should be kept up to date. They should be clear about how best to communicate with each person.

CARE HOME ADULTS 18-65 Bath Road, 85 85 Bath Road Worcester Worcestershire WR5 3AE Lead Inspector D Lewis Announced Inspection 28th October 2005 10:00 Bath Road, 85 DS0000018626.V261703.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 Bath Road, 85 DS0000018626.V261703.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. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Bath Road, 85 Address 85 Bath Road Worcester Worcestershire WR5 3AE 01905 360439 01905 360447 home@bathroad85.fsnet.co.uk 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) Mr David George Broadbent Miss Josephine Mary Fowler Care Home 5 Category(ies) of Learning disability (5), Sensory impairment (5) registration, with number of places Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service is for people with a learning disability who also have a hearing impairment. 9th November 2004 Date of last inspection Brief Description of the Service: 85 Bath Road is a large terraced house in Worcester, within walking distance of local amenities and the facilities of the city. The home provides accommodation in five single rooms for five younger adults with learning disabilities and profound hearing loss. The service aims to enable them to lead a normal life and gain fulfilment through support to develop skills in communication, social and daily living activities and to participate in further learning opportunities. The registered provider is Mr David Broadbent, who maintains a regular link with and oversight of the home and supervises the registered manager, Ms Josephine Fowler. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on a morning in October over 3 hours. It was this inspector’s first visit to the home. The aims were to meet service users and staff, and to follow up progress made since the last inspection in November 2004. The inspector was accompanied by a sign language interpreter, who is familiar with the home and the service users and whose help was much valued. The inspector met with 3 service users, spoke briefly with staff on duty and met with the registered manager and the registered provider. All were welcoming and helpful. The 3 service users kindly showed the inspector their rooms and provided other information. Service users seemed relaxed and all were getting on with their own particular activities for the day, helped by staff where needed. The inspector was pleased to note a lot of progress being made in the home. What the service does well: What has improved since the last inspection? What they could do better: Plans for how staff care for service users should be kept up to date. They should be clear about how best to communicate with each person. Bath Road, 85 DS0000018626.V261703.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. Bath Road, 85 DS0000018626.V261703.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 Bath Road, 85 DS0000018626.V261703.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): None These standards were not assessed, but in conversation the registered provider showed full awareness of the importance of reviewing service users’ needs. EVIDENCE: There had been no new service users for the past 5 years and no changes were planned. Bath Road, 85 DS0000018626.V261703.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): 6 Service user plans were in place and were accessible, working documents. They needed full information of all communication needs and they need to be regularly reviewed. EVIDENCE: Service user plans were sampled. They had been revised so all information was collated into one folder for each person. The registered manager said this was working well. Some work needed to be completed e.g. not all details of communication needs were in place. The registered manager described arrangements for reviewing service user plans. These reviews were not being held 6-monthly. Some were being done annually. Others, where there was no named social worker, had not been fully reviewed for some time. The registered manager agreed this was a priority and planned to implement structured reviews from the new year. The inspector was told that service users had little input to service user plans because of limits on their understanding. Their views were represented by staff’s knowledge and experience of each individual service user. This experience was apparent during the visit. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 10 (Standard 7 – it was noted that the ex-proprietor was still an appointee for some service users. These accounts were not being independently audited, as previously advised; however the inspector checked some of these financial records kept in the home, which were clear and were signed by the service user.) Bath Road, 85 DS0000018626.V261703.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): 17 Food provided was healthy. Service users had realistic choices and were fully involved in the planning and preparation of meals. EVIDENCE: The inspector saw detailed records of food for each service user. Service users showed or told the inspector how they chose their food, one commenting “I know what I want and what I like”. Clear pictorial menus were on display and pictures of a wide range of foods and meals were used to help service users plan meals. Options were available if required. Service users were encouraged to eat healthy diets e.g. not chips every day. The food records confirmed this. The other “lifestyle” standards were not inspected, but it was clear that service users were involved in a range of activities and were enabled to participate in the community and that families were welcomed and involved at the home. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 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): 19 Healthcare needs were efficiently recorded and monitored. EVIDENCE: The home had put into place Health Action Plans for each service user so records were accessible, comprehensive and up to date. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 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): None EVIDENCE: These standards were not assessed. An issue of concern was discussed between the inspector and the registered manager, and a course of action agreed. The registered manager showed awareness of the issues. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 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, 26, 29 The home was clean, comfortable and well maintained. Bedrooms were furnished and decorated according to individual service users’ tastes. The home had been adapted to meet the needs of service users. EVIDENCE: The inspector saw all shared areas of the home and 3 service users’ bedrooms. The home was comfortable, clean and well maintained. Some work was in progress e.g. a new kitchen and new patio doors had just been fitted. Other work was due to be carried out shortly e.g. some decoration, new carpets, and replacement windows. Bedrooms were well-decorated and clearly reflected individuals’ tastes. Suitable equipment was in place for the service users, including doorbells (on the front door and bedroom doors) and fire alarm systems, all of which used flashing lights. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 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): 32, 35 Staff were generally well trained and could communicate with service users. The registered provider had a training plan for individual staff and for the team. The plan was clearly linked to service users’ needs. EVIDENCE: The inspector saw staff training records. Staff had undergone considerable training in the past 2 years e.g. in 2004 most had done training in health and safety, medication, protection of vulnerable adults, and managing challenging behaviour; in 2005 most staff had done training in disability equality, and personal protection of staff. In addition, basic training continued on a rolling programme e.g. induction, food hygiene, fire safety, first aid. All staff were trained in sign language, to varying levels. All staff except a recent recruit held, or were due to complete, a NVQ 2 or 3 in care. Staff were relating to service users in a supportive and enabling way. The registered manager said that she would be arranging some training in total communication methods in 2006, to see if there were other ways in which staff could further improve communication with service users. There had not yet been sufficient time to undertake all desirable training. Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 16 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 The registered manager was experienced and well trained. She had almost completed the Registered Manager’s Award. The home had begun its process of quality assurance. EVIDENCE: The registered manager had worked at the home for 11 years, for 2 years as the deputy and then for the past 4 years the registered manager. She held the Advanced Management for Care certificate and was now doing the Registered Manager’s Award, which she was due to complete by spring 2006. The inspector agreed to advise on any further training needed. The home had begun a process of quality assurance which was due to be collated, and then repeated regularly. The inspector agreed to provide a possible format. (Standard 42 – it was not clear from records seen whether staff were receiving fire safety training 4 times a year. This will be checked on a future inspection.) Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 17 (Standard 43 – it was noted that the registered provider had prepared a business plan as previously recommended.) Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 18 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 Score X X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X 3 X X 3 X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X 3 X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Bath Road, 85 Score X 3 X X Standard No 37 38 39 40 41 42 43 Score X X 2 X X X X DS0000018626.V261703.R01.S.doc Version 5.0 Page 19 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 YA6 Regulation 15 Requirement Service user plans must cover all aspects of care as set out in Standards 6 and 2.3, specifically this must include assessments of communication needs and strategies for communication support. (Previous timescale of 31/03/05 not met) 2 YA6 15 Service user plans must be reviewed at least 6-monthly with recorded evidence to show this is done, and also to show that the views and wishes of service users and their representatives 31/03/06 are noted and taken into account. (Previous timescale of 31/08/05 not met) Timescale for action 31/12/05 Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 20 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA7 Good Practice Recommendations Where the home acts as appointee for service users’ finances the records maintained should be independently audited. It would be good practice to train all staff in risk assessment and risk management. The registered manager should follow up the issue discussed with the inspector at the inspection, and record the outcome. The registered provider should ensure that outstanding improvements to the home are completed as soon as possible, e.g. replacing worn carpet, refurbishment of bathrooms and toilets. The registered manager should arrange for staff to receive training in Total Communication methods. A copy of the report on the outcome of service users surveys, carried out as part of the quality assurance programme, should be provided to the Commission when completed. 2 3 4 YA9 YA23 YA24 5 6 YA35 YA39 Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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 Bath Road, 85 DS0000018626.V261703.R01.S.doc Version 5.0 Page 22 - 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. 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