Inspection on 06/09/05 for Blunt Street (9)

This inspection was carried out on 6th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Blunt Street (9) 23/12/08

Blunt Street (9) 19/12/07

Blunt Street (9) 11/01/07

Blunt Street (9) 13/02/06

Blunt Street (9) 14/02/05

Blunt Street (9) 12/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 9 Blunt Street Stanley Common Ilkeston Derbyshire DE7 6FZ Lead Inspector Tony Barker Unannounced 6 September 2005, 2.20pm th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 9 Blunt Street Address Stanley Common Ilkeston Derbyshire DE7 6FZ 0115 932 3508 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) United Response Christine Coates Care Home 4 Category(ies) of 4 - Physical Disability registration, with number 4 - Learning Disability of places 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Four (4) persons (of either sex) in the category adults with learning disabilities / adults with physical disabilities. Date of last inspection 14/2/05 Brief Description of the Service: 9 Blunt Street is a detached house in a small village development. Service users are provided with adequate accommodation and single rooms. There is a reasonably-sized rear garden. The Home offers personal and social care to people with a severe learning disability with associated conditions that include autism, sensory and physical disability and challenging behaviour. Activities are planned to meet individual needs. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The time spent on this inspection was 4.25 hours and was a routine unannounced inspection. The last inspection took place in February 2005 and was an unannounced inspection. This inspection was the inspector’s first visit to the Home. The Manager and her Service Manager were spoken to, records were inspected and there was a tour of the premises. One service user’s records were examined as part of the case tracking method. The focus of this inspection was on progress made on the requirements and recommendations made, and those standards not assessed, at the last two inspections. Due to the amount of staff attention required by service users during this inspection the number of standards inspected was less than planned. 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. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 6 contacting your local CSCI office. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) The standards in Section 1 were not assessed. EVIDENCE: 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 & 9 Service users’ needs were being fully considered but not reviewed adequately. Their safety had been thoughtfully planned through written risk assessments. EVIDENCE: The service user’s file examined contained a detailed individual care plan with care plan reviews being held annually and documents appropriately dated. The Service Manager said there were plans to have reviews every six months – with alternate reviews being held internally. All four service user files contained a recorded Life Plan that was a valuable person-centred document. There was evidence of detailed risk assessments in place in the file casetracked. The assessments covered all aspects of the service user’s care with appropriate reviews. One service user had perspex screens on his bedroom windows to prevent him from throwing objects through the window. There was no evidence of any statement in the care plan regarding restricted access to his window. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) Service users were offered a healthy diet. EVIDENCE: Written menus indicated that service users were provided with a varied and nutritious diet. Other aspects of Standard 17 were not assessed. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 Service users’ physical health needs were not being met. EVIDENCE: All service users were registered with the same GP practice. The Medical Profile, in the file case-tracked, although completed had not been reviewed since February 2004. The Record of Health Checks had no entries since December 2003, as at the last inspection. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 12 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The views of service users and other stakeholders were being listened to and acted on. Service users were being protected from abuse by the Home’s procedures and by a staff group who, with some exceptions, were well trained. EVIDENCE: United Response had a robust procedure for dealing with complaints. Two complaints had been received during the 12 months previous to this inspection and both were found substantiated. They originated from neighbours unhappy with the noise emanating from the Home. The Manager provided details of a constructive plan to address these issues – some parts of which were already working. There was on-going discussion with the neighbours. Links had been developed with two advocacy groups: South Derbyshire Advocacy Group and the Autistic Support Group. The Service Manager said that all staff had received training regarding the protection of vulnerable adults. Staff training records showed that, although most staff had received SCIP training, this was not being kept up to date. There had been one Adult Protection investigation during the 12 months previous to this inspection – regarding an incident between two service users. This showed that the Home’s procedures for dealing with suspected abuse were working. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,26,29 & 30 Service users were living in a generally safe environment. However, in certain rooms it was not homely and was in need of repair and refurbishment. One bedroom was non-hygienic. Service users’ independence was being maximised through environmental adaptations. EVIDENCE: A number of environmental improvements to the premises had been made since the last inspection: walls had been decorated, Velcro was being used to keep curtains up and a bedroom window closure had been replaced. However, a first floor toilet cistern had been repaired only to become damaged again. Additional items needing attention were… • the perspex screens on one service user’s bedroom windows had come adrift, • there was no window blind in the bathroom, two wall tiles were missing and the painted window frames were peeling in here, • external bolts on the WC and bathroom doors could be abused (These were removed during the inspection), • there were no light shades in the lounge, • there were no soft furnishings and no curtains/blinds in the dining room, • walls in the lounge and dining room were bare and there was a discussion with the Manager about a practical way of displaying wall pictures, 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 14 • the hall carpet was very stained in front of the kitchen, • the landing carpet was stained and had an offensive odour (This matter was raised at the last inspection). While it is accepted that much of the above is the result of service user behaviour it was the inspector’s opinion that closer management oversight was needed in order to maintain a homely environment. One bedroom had a ceiling damaged by water, a carpet in poor condition and had no window blind. Another service user’s bedroom had a range of visual aids to reflect her needs. There was equipment in place in the bathroom to address the needs of one physically disabled service user. This comprised a ‘rise and fall’ sink, a ‘dropping’ rail by the WC and a hand-rail to the other side. Standards of cleanliness and hygiene at the Home were satisfactory – apart from the odorous carpet mentioned. There were no specifically designated staff for domestic work and service users were involved in this activity following assessments of capability and safety. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,34,35 & 36 Service users were not being fully protected by the Home’s recruitment procedures. Their needs were being met by staff who were generally welltrained although not consistently on all topics. This staff group was not being fully supported and supervised. EVIDENCE: 30 of the staff group held a qualification to at least National Vocational Qualification (NVQ) in Care at level 2. The Manager spoke of the need to motivate non-qualified staff to achieve NVQ level 2. The Manager was hoping to start three new staff soon – leaving just one vacancy for a waking member of night staff. Other aspects of Standard 33 were not assessed on this occasion. One staff member’s file was inspected. Her job application form had been left blank in the columns titled ‘Dates Employed’ and ‘Reasons for Leaving’ and there was no other documentation addressing these areas. Also, there was no photograph of the member of staff on file. Other items required by Regulation were in place. The Manager confirmed that all staff had a satisfactory CRB disclosure in place. The Manager confirmed that the new members of staff would be undertaking induction training, using the Learning Disability Award Framework, within six 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 16 weeks of appointment. Copies of the staff group’s training matrix were on individual staff files though these were not up to date. The Manager produced an up to date copy of the matrix which indicated that not all staff had been provided with training on four mandatory subject areas within the past three years. Staff records showed that staff were receiving supervision at irregular periods. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The safety of service users was not being fully promoted by means of regular fire drills and practices. EVIDENCE: Cleaning materials were kept in a cupboard in the locked laundry room. The cupboard had just had its lock broken. Product Information Sheets were kept in an adjoining cupboard. The pre-inspection questionnaire indicated that all equipment was being maintained and serviced at appropriate intervals. This document showed the last fire drill taking place in April 2005 but there was no recorded evidence in the Home of a fire drill since 2003. The Service Manager said that all staff had received instruction, in the control of infection, at a team meeting. 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 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 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x 2 x x 3 2 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x 3 x 2 2 2 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 9 Blunt Street Score x 2 x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 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. 2. Standard 6 19 Regulation 15(2)(b) 17(3)(a) Requirement Service users care plans must be reviewed at least every six months The manager must ensure that records are kept up-todate.(Previous timescale was 31/3/05). The registered person must ensure that administration records for medicines are properly and completely maintained.(This requirement from 12/8/04 was not assessed) The registered person must arrange with the home’s pharmacist for a suitable dispensing system for medicines to be administered to service users away from the home by third parties.(This requirement from 12/8/04 was not assessed) The manager must ensure that staff receive training suitable for their work.(Previous timescale was 30/4/05) Damaged items and others in need of maintainance, identified in this report, must be repaired or replaced. Some carpets must be replaced. Timescale for action 1 January 2006 1 November 2005 1 November 2005 3. 20 13(2) 4. 20 13(2) 1 December 2005 5. 23 18.1(c)(i) 1 January 2006 1 February 2006 1 February 2006 Page 20 6. 24,26 23(2)(b) 7. 24,26 16(2)(c) 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 8. 9. 24,26 24 16(2)(c) 23(2)(a) Curtains, blinds and light shades must be put in place. The lounge and dining room must be made more comfortable and homely through the use of wall pictures, for instance. Records of staff employed at the home must be as defined by (the revised) Schedule 2.(Previous timescale was 31/3/04). Staff must receive training in mandatory topics and be provided with top-up training at least every three years excepting fire training which must be more frequent. All staff must receive formal supervision at least six times a year. The manager must ensure that fire drills take place at least twice a year and records of these drills kept within the Home. 1 December 2005 1 January 2006 1 January 2006 1 February 2006 10. 34 19 Sch 2 11. 35 18.1(c)(i) 12. 13. 36 42 18(2) 23(4)(e) 1 December 2006 1 December 2005 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 1 Good Practice Recommendations The registered person should rename the Individual Contracts of residence issued to service users to include reference to the service users guide.(This recommendation from 12/8/04 was not assessed) The manager should ensure that risk assessments are in place for restrictions on service users.(This was a recommendation from 14/2/05) 50 of staff should achieve a National Vocational Qualification (NVQ) to level 2 or above by 31 December 2005. The lock to the cleaning materials cupboard should be replaced. 2. 3. 4. 9 32 42 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection South Point, Cardinal Square Nottingham Road Derby DE1 3 QT 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 9 Blunt Street C02 C52 S19939 9 Blunt Street V247356 060905 Stage 4.doc Version 1.40 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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