Inspection on 09/06/05 for Cardinalls Road

This inspection was carried out on 9th June 2005.

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.

Other inspections for this house

Cardinalls Road 20/10/08

Cardinalls Road 26/10/06

Cardinalls Road 31/10/05

Cardinalls Road 03/02/05

Cardinalls Road 27/09/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Cardinalls Road 43 Cardinalls Road Stowmarket Suffolk IP14 5AA Lead Inspector Kevin Dally Unannounced 9th June 2005 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. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Cardinalls Road Address 43 Cardinalls Road, Stowmarket, Suffolk, IP14 5AA 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) 01449 677527 Royal Mencap Society Miss C A Smylie Care Home 3 Category(ies) of Learning Disability (3) registration, with number of places Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3/2/05 Brief Description of the Service: The primary role of staff in this service is to prompt, encourage and support the service users to maximise their skills, abilities, and interests. This to provide service users with opportunities to pursue active lives in the community and to access a range of services and facilities available to them.Cardinals Road is a 3-bedded Home for people with learning difficulties and is centrally placed in relation to facilities and transport in the town of Stowmarket.All three service users are female and form an established group having lived together in this environment for a significant period. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Thursday 9th June 2005 between 15.15 and 21.30 by Kevin Dally and Jane Offord, inspectors. The inspectors were able to speak to all three residents, the manager and one member of staff. A meal was shared with the residents which took place in a relaxed, family-like atmosphere. Access was given to one individual’s room and the communal areas of the home were looked at, all of which were comfortable and clean. Care plans, risk assessments and personal details for two of the residents were seen, as were recruitment details and training for one member of staff. Interaction observed between staff and residents was caring, respectful and appropriate. What the service does well: What has improved since the last inspection? Since the last inspection staff have incorporated the de-escalation training they undertook into their support of one of the residents who can demonstrate challenging behaviour. The staff have recognised the success of their new working technique. Following a visit from the fire officer, a recommendation to have an automatic release on the laundry door to improve fire safety, has been implemented. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 6 Following recommendations at the last inspection there has been work done in areas that were of concern such as boxing in piping in the bathroom and wiring on the landing. 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. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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 Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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) 2. Prospective residents can expect that a complete assessment of their needs will be undertaken prior to using this service. EVIDENCE: There have been no new residents for a considerable period of time but the records of one resident showed a comprehensive assessment that had been undertaken before admission. There were fifteen headings for assessment that covered physical, emotional and social needs and personal preferences and abilities. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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) 7,8,9 In this service residents are supported to make decisions about the way they spend their time, participate in the running of their home and staff undertake individual risk assessments to support their chosen activities. EVIDENCE: During the inspection the three residents returned from the resource centre they attend four times a week. They were happy to share with the staff what they had been doing during the day including having ‘fish and chips’ for lunch. The resource centre is within walking distance but the other side of a level crossing. Staff accompany the residents to the centre and meet them at the end of the day. A risk assessment has been developed for one resident, who can demonstrate challenging behaviour, in the event of them stopping on the level crossing and refusing to co-operate with the staff member. The residents told the inspectors of trips they had made to the cinema, theatre, seaside and pop concerts. They indicated that these outings were their choices and they were not obliged to go if they chose not to. They are at present planning a holiday in Great Yarmouth. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 10 One resident who has a significant sight impediment attends a craft group in a nearby village twice a month. They also have friends in the community who accompany them out and on the day of the inspection had been to Needham Lake with a friend. In the home there was evidence of games, music and a television available for the use of the residents. One resident liked pictures of mechanical things and the inspectors were asked to draw trains and a helter-skelter at their request with a selection from the numerous crayons and felt tip pens available. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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 standard(s) 12, 13, 14, 15, 16, 17 This service enables residents to participate in appropriate leisure activities in the community and supports them to maintain contact with families and friends. Residents can expect to have their choice of activities respected. The service offers menus with a wide variety of healthy food. EVIDENCE: One resident told the inspectors of their visit to the hairdresser and that there is a minibus available for use on certain days if they want to go further afield. The staff help with shopping trips and can book the Rethink Disability transport if required. In the personal records there were details of family members, their relationship to the resident and contact details. One resident has recently moved into a single room from shared accommodation and the family were included in the preparation of the resident for the change. There were explicit details in the care plan of the family involvement. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 12 One resident enjoys sending birthday cards to members of their family and a birthday date list is kept in their bedroom. Staff assist in choosing the cards. The care record details visits from family members and one resident regularly spends a weekend away from the home with parents or sibling. The residents are encouraged to help with the day to day running of the home by keeping their rooms tidy, hoovering, washing up and putting away their own laundry. The staff respect the privacy of the residents and were observed knocking on doors before entering. Staff spoken with were clear that this was the home of the residents and their wishes were paramount. The residents were able to adapt the home routine to suit themselves. One resident said they could have a bath whenever they wished. Cooked meals were often eaten at the resource centre but the freezer did contain a wide variety of ready meals and the larder and refrigerator were well stocked with fresh produce. The menus seen reflected a mixed use of freshly prepared meals and convenience meals. Two of the residents have a problem maintaining an ideal weight and the staff encourage varied dietary intake including ‘healthy eating’ options. On the day of the inspection the residents had eaten ‘fish and chips’ at the resource centre so they chose sandwiches for supper. There was a wide variety of fillings, fresh salad and a large choice of fresh fruit or yoghurts. The residents were encouraged to make their own sandwiches. One resident with a significant sight impediment made their own sandwiches with verbal guidance from a member of staff. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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 standard(s) 18, 19, 20, 21 Residents’ personal support is met sensitively by the staff. The health and emotional needs of residents are met in partnership with appropriate professional input when needed. Residents cannot be assured that individual staff members are competent to administer medication under the present training sequence. EVIDENCE: The care plans seen on the day of inspection showed in great detail the individual preferences of the residents for the way their personal care is managed. One resident needs to have facial hair removed and the care plan identified the method and the member of staff they preferred to do the task. Care plans detailed emotional triggers for staff to be aware of and strategies for managing the behaviour. One care plan recorded the way in which the resident expressed affection or emotional stress. Records were seen of visits made to or by the GP and the details of care/medication prescribed. There were also records of appointments with other professionals such as dentist, hospital consultants, chiropodist and optician. One resident with limited communication ability had recently been unwell. The staff had taken them to the GP and were monitoring the resident to assess the effectiveness of the treatment prescribed, at the request of the GP. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 14 There are policies and procedures in place to protect the residents in the administration of medication, however the sequence of induction training means that staff may not have completed the medication training before working alone and being responsible for medication administration. The manager must assess the competence of individual staff members before they are able to administer medication alone. One completed incident form was for a medication error. The form recorded the appropriate actions taken as a result of the error. On the day of inspection a medication recording error was noted. These incidents were discussed with the manager who acknowledged that medication training for staff was required. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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 standard(s) 22, 23 The service encourages residents and their families to express their views about the service. Residents cannot be assured that the present sequence of training in the induction programme will give staff the information required to protect them from abuse at an early enough date in their employment. EVIDENCE: Neither the home nor CSCI have received a complaint about the service in the last twelve months. Relatives returned eight satisfaction surveys and all the comments were good. One relative said that they were ‘always made to feel welcome’. Another relative put ‘I cannot praise too highly the kindness and caring attitude of all staff whilst retaining a professional manner’. There were positive comments on all aspects of the care given from personal care, social and leisure activities to the atmosphere in the home. All staff have a POVA First and CRB check undertaken prior to taking up a post. However the training to recognise abuse and the referral procedure to follow does not form part of the initial six-week induction but is covered in the first six months. Staff said that carers would be rostered to do lone working after the initial six-week training is complete. Consideration must be given to altering the sequence of the induction training programme to include Protection of Vulnerable Adults training, before staff commence lone working, to ensure protection for residents. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 27, 28, 29, 30 This service offers residents a clean well-run environment that is adapted to meet individual needs and promote independence. EVIDENCE: The resident’s bedroom that was seen on the day of the inspection was tidy, personalised and was furnished with furniture entirely chosen by the resident. There were pictures of animals on the walls and a variety of stuffed toys including a nearly life size tiger of which the resident was very fond, the manager said. The bedside lamp was a touch lamp to allow the resident the control of the lighting. The temperature of the water in the bath and shower were tested and were forty-three degrees and forty-one degrees respectively. Water pipes in the bathroom that were identified at the last inspection as a potential danger and unsightly have been boxed in and painted. Electrical wiring on the landing has also been covered. Unused sockets in the kitchen were fitted with protective socket guards. The temperature of the refrigerator and freezer were taken and Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 17 recorded daily. The records showed that they maintained temperatures within safe limits for the storage of food. There is an area of plaster in the toilet on the half landing that is in need of repair. The toilet will then require redecoration and the present ceiling height makes that a health and safety risk for the staff to undertake it. The room that is used as a staff sleep room and an office would benefit from being tidied and decluttered. The paintwork there and in some communal parts of the home needs refreshing but as the staff are the people to undertake that and there are staff vacancies at present this is not one of their priorities. One resident with a significant sight impediment is able to negotiate the home using furniture to orientate themselves. The staff are aware that certain pieces of furniture must remain in place to facilitate that. The resident has a white stick for use outside the home. There is a supply of sugar cubes for the drinks of this resident to allow them to add sugar independently as they have difficulty with spoons and spatial awareness. This resident said they ‘felt safe’ in this home. They said they had come from a previous home where there had been issues about safety. The laundry area was clean and adequately equipped. Cleaning materials and hazardous substances were locked in a cupboard. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 18 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, 33, 34, 35, 36 The staff team demonstrated commitment to supporting the residents in their chosen life styles. Residents cannot be confident that the present induction training sequence will give staff the knowledge to protect them from abuse early enough in their work. EVIDENCE: The manager has been in post a number of years and has developed an ethos in the home, which means the residents’ wishes are paramount. The staff team demonstrated in their interaction with the residents that they worked with that example and the residents were confident in their approaches to staff members. The staff team is depleted at present with one vacancy of fourteen hours, one staff member in hospital and one part time, sixteen-hour a week, staff member on long term sick. There were no unfilled shifts on the rotas as existing staff were working extra and the service has a number of dedicated ‘relief’ staff. No staff members were being put under pressure to work extra. The shifts they chose fitted with their own life style. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 19 The recruitment policy for the service was robust and the staff file seen contained all the checks required to work with these residents. There were comprehensive minutes of staff meetings, which were held regularly and showed that a wide range of topics and issues were discussed. Staff supervision was undertaken by the manager twice monthly and staff spoken with felt they could comfortably raise any issues that concerned them at supervision. The staff team were supportive to each other. A member who had recently taken up post had experienced some difficulties with one of the residents. They had discussed this with other team members and were reassured that the behaviour was not personal but the way that resident managed changes. There is a comprehensive induction training programme that is part of MENCAP policy for new staff members. There is an initial six-week period and then the full induction is completed in the first six months. A staff member can be required to undertake lone working after the first six weeks training is completed. The sequence of the training means that Abuse of Vulnerable Adults and Health and Safety training is not part of the first six weeks. This could potentially put staff and residents at risk because of lack of knowledge. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 20 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) 37, 38, 39, 40, 41, 42, 43 The service is run to promote the rights and best interests of the residents and has the necessary policies and procedures in place to achieve that with the exception of those already referred to in this report. EVIDENCE: The service is set in a building which allows a homely atmosphere and has the advantage of being within easy access of local amenities which the residents enjoy. Staff are clear in the way they work that this is the residents home and their rights and wishes are respected. The manager was concerned that if the residents returned from the resource centre to find visitors in their home it might upset them and requested that the inspectors remain in the office until they could be introduced. One member of staff spoken with stated that the right of the residents to choose what attire they wore around the home was respected, but they Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 21 encouraged residents to dress appropriately in the communal areas to preserve their dignity. The records seen were comprehensive and informative. They were individualised and risk assessments were generated to safeguard the residents in their chosen activities. Cardinalls Road I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 22 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 x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Cardinalls Road Score 3 3 2 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 2 3 3 3 I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 23 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. 1. Standard 20 Regulation 18 (1) Requirement Timescale for action immediate 2. 24.1 23 (b)(d) 3. 23 13 (6) Medication training for one staff member who must be supported with medication administration until the training is completed and they are assessed as competent. The hole in the plaster of the 22/9/05 wall of the toilet on the half landing must be repaired and the toilet then decorated. The sequence of the induction immediate training must be varied to ensure the staff receive health and safety, protection of vulnerable adults and medication training before undertaking lone working. 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 24.12 Good Practice Recommendations The room used as an office and staff sleep room should be tidied and decluttered. The paintwork in there and in some communal parts of the home should be redecorated. I54-I04 S24541 Cardinalls Road V232471 050609 Stage 4.doc Version 1.30 Page 24 Cardinalls Road Commission for Social Care Inspection 5th Floor, St Vincent House Cutler Street Ipswich IP1 1UQ 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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