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Inspection on 10/02/06 for Brain Injury Services, 51 The Drive

Also see our care home review for Brain Injury Services, 51 The Drive for more information

This inspection was carried out on 10th February 2006.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

Staff are very supportive of each other and residents. Prior to this inspection a senior member of staff on duty at 49 The Drive was able to give the inspector a brief overview of residents needs to ensure that the inspection had minimal impact on residents routines and behaviours. Residents were satisfied with the level of care and support that they are receiving which is based on their individual needs. There is a comprehensive assessment and care planning process in place, which supports and encourages residents in achieving set goals as part of their rehabilitation programmes and maximises their independence.Staff have a good understanding of the needs of residents and have developed good relationships with them. Residents are clear about how to raise any concerns and are satisfied that action would be taken to address any issues that may arise.

What has improved since the last inspection?

Resident`s care plans contained contact information for families and friends.

What the care home could do better:

A recommendation has been made regarding the practice of referring to residents in records as numbers. Although staff on duty at the time of the inspection treated residents with dignity and respect the practice has the potential to depersonalise residents.

CARE HOME ADULTS 18-65 Brain Injury Services, 51 The Drive 51 The Drive Northampton Northants NN1 4SH Lead Inspector Mrs Kathy Jones Unannounced Inspection 10 February 2006 01:00 Brain Injury Services, 51 The Drive DS0000012718.V264359.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 Brain Injury Services, 51 The Drive DS0000012718.V264359.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. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Brain Injury Services, 51 The Drive Address 51 The Drive Northampton Northants NN1 4SH 01604 233482 01604 638176 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) Partnerships In Care Limited Mrs Helen Elizabeth Storr Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (3) of places Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. All service users will have an acquired Brain Injury. Age Range 30 - 60 Years of age Date of last inspection 19 September 2005 Brief Description of the Service: 51 The Drive is a Care Home providing personal care for 3 service users with acquired brain injury. The home is owned by Partnership in Care Limited and is adjacent to another home owned by the same company. The Registered Manager is Mrs. H. Storr who has experience in her client group and who is also the Registered Manager for the adjacent home at number 49 The Drive. The home is located in a suburb of Northampton close to a local shopping centre and park and easily accessible by public transport. The home was opened in January 1994 and consists of a large semi-detached house with front and rear gardens. Single room accommodation without en suite facilities is provided for all service users. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out over approximately two and quarter hours on the afternoon of a weekday. 51 The Drive was inspected on the morning of the same day and through discussion with staff during that inspection staff had some prior notice of the inspection. 49 and 51 The Drive are owned by the same organisation and managed by the same manager therefore the same procedures and practices are in place. In view of this information gathered relevant to both homes has been included in this report. Prior to the inspection the inspector spent one and a half hours reading the homes service history and previous inspection report. This information informed the planning of the areas to be inspected. A sample of residents records were reviewed to check how their care needs had been assessed and how their care is planned and supported. The inspector spent some time talking to residents and staff about the care provided. Observations of the daily routines and interactions between staff and residents were made throughout the inspection. A sample check of the medication system was made. Records relating to quality assurance processes and staff recruitment were not accessible during this inspection as the manager was not on duty. These areas were assessed through discussion with staff. Recruitment procedures were discussed with a relatively new member of staff. What the service does well: Staff are very supportive of each other and residents. Prior to this inspection a senior member of staff on duty at 49 The Drive was able to give the inspector a brief overview of residents needs to ensure that the inspection had minimal impact on residents routines and behaviours. Residents were satisfied with the level of care and support that they are receiving which is based on their individual needs. There is a comprehensive assessment and care planning process in place, which supports and encourages residents in achieving set goals as part of their rehabilitation programmes and maximises their independence. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 6 Staff have a good understanding of the needs of residents and have developed good relationships with them. Residents are clear about how to raise any concerns and are satisfied that action would be taken to address any issues that may arise. 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 contacting your local CSCI office. Brain Injury Services, 51 The Drive DS0000012718.V264359.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 Brain Injury Services, 51 The Drive DS0000012718.V264359.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): 2, 5 The admission process provides assurances that the needs of Residents entering the home can be met. EVIDENCE: The organisations procedures in relation to assessment of a prospective resident were reviewed during an inspection carried out on the same day at the adjacent home. These records confirmed that there is a comprehensive assessment process in place. A detailed assessment of needs is compiled with the involvement of the prospective resident, relatives and relevant health professionals. Information is gathered about the prospective residents history prior to and progress following the brain injury to aid understanding of the individual. A copy of a written “contract for living” which sets out the terms and conditions of residence in the home are held on resident’s files. The contracts are signed by the resident and the registered manager. Brain Injury Services, 51 The Drive DS0000012718.V264359.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, 10 Residents receive a good level of care and support appropriate to their individual needs and goals however the practice of referring to residents as numbers within their records has the potential to depersonalise them. EVIDENCE: A sample check of a resident’s care plans confirmed that detailed care plans are in place to guide and instruct staff as to the individual care and support required. Staff have a good knowledge of residents as individuals and of their care and support needs. Care plans are based around supporting and encouraging residents to regain skills that have been impaired or lost through brain injury. This is achieved through a regular assessment, which is carried out at least every three months, taking account of progress in achieving set goals. Alongside the review of residents needs there was evidence from discussion with staff of regular review of the homes ability to meet residents assessed needs. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 10 Discussion with residents about the care and support provided confirmed that they were aware of and involved with their individual programmes and satisfied with the support provided. The inspector was concerned to note that although some of the homes records referred to residents by name however others referred to them as a number. Staff informed the inspector that this practice is in place to protect resident’s confidentiality. However resident’s records are securely stored and staff confirmed that they are never made accessible to anyone who is not authorised to see them. Although staff were observed and spoke of residents as individuals it is of concern that the practice of using numbers instead of names appears to have no purpose and has the potential to depersonalise residents. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): 20 The overall management of resident’s medication is good. EVIDENCE: A sample check of the medication system confirmed that medications are securely stored and in the majority of cases two staff prior to administration check medication. Stock levels of medication are not excessive and there is a procedure in place for recording the dates of opening on creams and eye and ear drops which have a limited shelf life when opened. One medication for occasional use was found to have passed its expiry date. Staff confirmed that it hadn’t actually been used beyond the expiry date and undertook to arrange a new supply in case required. Medication training records were not checked on this occasion however no concerns were identified with the management of medication. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): 22, 23 Staff are aware of their responsibilities in relation to adult protection and residents know how to raise any concerns. EVIDENCE: The Commission for Social Care Inspection have received no complaints since the last inspection. The manager was not in the home at the time of the inspection however staff were not aware of any complaints. Residents confirmed that they had no concerns and confirmed that they were aware of the process for making a complaint and were satisfied that any necessary action would be taken. A hypothetical scenario discussed with a member of staff confirmed that they have a good understanding of their responsibilities in relation to adult protection. A new staff member informed the inspector that adult protection procedures form part of the induction programme, which is undertaken prior to working with residents. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection however the communal areas of the home were clean and comfortably furnished. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): 34 A thorough recruitment process is in place, which provides safeguards for residents. EVIDENCE: Staff records were not available during this unannounced inspection as the manager was not on duty. Discussion with a new member of staff confirmed that a thorough recruitment process had been carried out which included an interview. The staff member advised that new staff do not start work until satisfactory references and a criminal record bureau clearance have been obtained. Brain Injury Services, 51 The Drive DS0000012718.V264359.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): 39 Systems are in place to review the standards of care and support provided to residents. EVIDENCE: Discussion with staff identified that systems are in place to review the quality of care provided however they were not aware of all of the details of the quality assurance system. Staff advised that a representative of the organisation carries out monthly unannounced visits to check standards of care in the home. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 17 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 3 X X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X X 2 Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 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 X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Brain Injury Services, 51 The Drive Score X X 3 X Standard No 37 38 39 40 41 42 43 Score X X 3 X X X X DS0000012718.V264359.R01.S.doc Version 5.0 Page 18 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. 1 Refer to Standard 10 Good Practice Recommendations It is strongly recommended that the practice of referring to residents as a number cease. Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Brain Injury Services, 51 The Drive DS0000012718.V264359.R01.S.doc Version 5.0 Page 20 - 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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