Inspection on 15/09/05 for Self Unlimited Rowde

This inspection was carried out on 15th 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Self Unlimited Rowde 19/03/08

Self Unlimited Rowde 14/07/06

Self Unlimited Rowde 06/03/06

Self Unlimited Rowde 14/03/05

Self Unlimited Rowde 04/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 CARE Rowde Furlong Close Rowde Devizes Wiltshire SN10 2TQ Lead Inspector Malcolm Kippax Unannounced Inspection 15th September 2005 1:25 CARE Rowde DS0000028267.V254162.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 CARE Rowde DS0000028267.V254162.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. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service CARE Rowde Address Furlong Close Rowde Devizes Wiltshire SN10 2TQ 01380 725455 01380 729030 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) www.care-ltd.co.uk CARE (Cottage and Rural Enterprises Ltd) Miss Tracy Elizabeth Redshaw Care Home 36 Category(ies) of Learning disability (36) registration, with number of places CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of service users receiving residential care and accommodated in the bungalows known as Alder, Fern, Hawthorn and Myrtle must not exceed 9 in each bungalow. The Commission for Social Care Inspection agrees that statutory records may be kept in the central administration office located on site. The Commission for Social Care Inspection agrees that medication kept on behalf of service users may be kept in the central administration office located on the site. Any statutory records kept and the arrangements, handling and recording, storage and safe keeping of medications kept on behalf of residents must be open to inspection at all times. 2. 3. 4. Date of last inspection 14 March 2005 Brief Description of the Service: CARE Rowde opened in March 1994 and is run by the registered charity, ‘Cottage and Rural Enterprises Ltd.’. CARE Rowde ‘meets the needs of those with a mild or moderate learning disability. It also meets the needs of those with more complex needs and some behaviour which can challenge’. (Statement of Purpose, CARE Rowde). Although managed as a single establishment, the accommodation for service users is provided in four separate, self-contained bungalows. These are known as Alder, Fern, Hawthorn and Myrtle. Each bungalow provides accommodation for up to nine service users, including one person in a self-contained flat. The facilities in each bungalow include a lounge, a kitchen / dining room, and a utility room. The bungalows were purpose built as part of a complex that also includes workshops, an I.T. suite, a communal hall / dining area and a central office block. There are grounds around the site that are for recreational and horticultural use. Many of the service users use the on-site facilities during the day and people also attend from the local community. There is one staff team that supports service users in the bungalows and another that provides support and supervision with the day activities. Administrative support for the residential and day services is provided by staff working in a central office block. The registered manager is a member of the on-site management team. The complex, including day facilities, is known as CARE Wiltshire. home establishment is registered in the name of CARE Rowde. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 The care Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection started at 1.25 pm and took place over 5½ hours. Service users and staff members were spoken with in Myrtle and Alder bungalows. Other service users were met with during a tour of the site and day facilities. The manager spoke about some recent developments. Examples of records were looked at in the central office block and in the two bungalows. What the service does well: What has improved since the last inspection? What they could do better: ‘Action Plans’ are produced with service users, which include details of their personal goals. Progress with completing these should be better monitored to ensure that goals are achieved without undue delay. This was also mentioned at the last inspection. The home also needs to ensure that inspection requirements are completed within the stated timescale. This includes the need to assess whether service users are safe when they stay in the bungalows without a staff member present. Two immediate requirement notices were issued because previous requirements had not been met. Procedures for the reporting of allegations of abuse must improve. CARE Rowde DS0000028267.V254162.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. CARE Rowde DS0000028267.V254162.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 CARE Rowde DS0000028267.V254162.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): These standards were not looked at on this occasion EVIDENCE: CARE Rowde DS0000028267.V254162.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 and 7 Service users benefit from the information that is included in their care and support plans. Service users have their own personal goals although support with achieving these is inconsistent EVIDENCE: Examples of the service users’ care plans were looked at in ‘Myrtle’ and ‘Alder’ bungalows. These were written from a service user’s prospective and gave an individual account of the service users’ needs and wishes in respect of personal support. The care plans are readily accessible to staff members and the staff members met with were aware of their contents. The plans had been written during 2005 and are reviewed every six months. ‘Action Plans’ are also produced following discussion between service users and their key workers. Service users spoke about their various interests and things they would like to do. The examples given included looking after a pet, going to the theatre, attending a gym and making a three course meal. The action plans seen included a range of objectives that promote independence and the service users’ involvement in new activities. As reported at the last inspection, ‘achieve by’ dates and the completion of objectives are not always recorded. The objectives in one service user’s 2004 action plan had been repeated in CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 10 their 2005 plan without any record of the progress, or lack of progress, that had been made. A more consistent monitoring of progress would help service users to achieve their objectives without undue delay. The objectives identified in the action plans reflect the decisions that service users have made about their individual activities and what they want to do. Risk assessments have been undertaken when decisions have needed to be made about the service users’ participation in activities that include a degree of risk. Key workers provide support with decision making. Review meetings are held, to which family members and outside professionals are invited to contribute. Service users participate in the domestic tasks and are encouraged to make decisions about the daily arrangements, such as menus and social events. During the inspection, service users in both bungalows were helping to prepare the tea meal and enjoying being involved in this. Service users are kept well informed of developments through a range of meetings that are held in the bungalows and on the CARE Wiltshire site. CARE Rowde DS0000028267.V254162.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): 12, 15 and 17 Service users are well occupied and can meet with people outside the CARE Wiltshire site. Service users have developed relationships that are important to them. Service users enjoy their meals, which they can help to choose and prepare. EVIDENCE: During the day, the majority of service users use the on-site day facilities and mix with others who are visiting for the day. From conversation with service users this appears to be a positive way in which they can make new friends and have contact with people outside the CARE Wiltshire site. One of the service users met with said how much he enjoyed staying in one of the bungalows as a change from his permanent home. The CARE Wiltshire site provides opportunities for developing skills in a range of areas including, horticulture, office work, crafts, catering and food produce. Service users looked well occupied in the different workshops and spoke enthusiastically about the work that they do. One service user met with also CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 12 enjoyed having a part time job outside CARE Wiltshire at the weekends. He was able to get to this job independently. The service users’ care plans include a section on ‘family’, where information about relationships, birthdays and friendships is recorded. Service users talked about the friendships they have made with people who live at CARE Wilshire and attend the day facilities. Two service users have got married during the last year. Service users who stay on the CARE Rowde site have a two course meal at 1 pm in the central dining room. There is a choice of menu for this meal, which includes cooked dishes and a salad bar with healthy options. Some service users had helped to prepare the lunch as part of their day’s work. Other meals are taken communally in the bungalows. The service users enjoyed their tea meal in one of the bungalows during the inspection. Service users write a menu for a week ahead with the support of staff. It was evident that there is a flexible approach to what is prepared and that service users can have something different to the planned menu if they wish. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 Service users receive the support that they need and are encouraged to express their views. EVIDENCE: Service users have their own rooms in which they can be private in their personal care routines. Many of the service users’ action plans included objectives about being more independent with their personal care and taking greater responsibility in their lives. The service users’ care plans showed that they had been asked about their wishes for personal support and how this is provided. This included the service users’ preferences for receiving personal care from staff members of the same gender. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 14 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 and 23 Complaints are dealt with in an appropriate manner and service users have the opportunity to raise concerns. Changes in the policy on abuse will be beneficial. Allegations of abuse were not reported within the agreed timescales. EVIDENCE: A record of complaints is kept in the central administrative block. This included the details of a complaint that had been made by a service user’s parents since the last inspection. This had been appropriately followed up. In discussion with service users it was clear that they felt able to see the manager or a staff member if they were not happy with something. A complaints procedure was seen displayed in one of the bungalow kitchens. This referred to the National Care Standards Commission but did not include an address or telephone number for the Commission for Social Care Inspection. It was reported at the last inspection that a range of guidance is available to staff about adult protection procedures and the recognition and reporting of abuse. A recommendation was made about reviewing the contents of the procedure file to ensure that this only includes the appropriate and up to date information. The file contained various policy and guidance documents that dated back to 1994/5 and were no longer relevant. The manager said that a revised policy about abuse had now been produced in draft form. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 15 Two written notifications were received at the start of the inspection. These concerned allegations of physical assaults involving service users, which had been reported by staff on 2 September 2005. These incidents are reportable under Regulation 37 of the Care Homes Regulations 2001, and as such the Commission needed to be notified of their occurrence without delay. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 Service users like the facilities at CARE Wiltshire and the accommodation is meeting their needs EVIDENCE: The premises were purpose built and the layout of the bungalows gives the impression of a residential estate on a private road. The site is relatively new (1994) and major refurbishment has not been needed. There is convenient access from the bungalows to the other on-site facilities. The CARE Rowde site as a whole looked tidy and well maintained. Within the bungalows, each service user has their own room, which they can personalise as they wish. The bungalows are spacious and the home has been commended at previous inspections for the range and size of the communal space that is available. Entrance halls and corridors provide good access to the different communal areas and the bedrooms. The two lounges seen were well decorated and comfortably furnished. Other areas were available for dining, computer use and for meetings or quiet activity. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 17 There are separate facilities for staff that include an office / sleeping-in room with en-suite area. The bungalows had their own gardens / parking areas, with additional space available around the CARE Rowde site. Service users are able to look after a small pet. Service users said that they like their rooms and also like to use the lounge, where they can meet together and watch television. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 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 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): 33 Staffing levels vary within the bungalows. Some one-to-one support is available, although the absence of staff on occasions may put service users at risk. EVIDENCE: A written staff roster is kept for the bungalows. There is usually one person working in each of the bungalows when the service users are present. Further one-to-one support is available for some service users, as agreed with the funding authorities. The manager said that there had been an increase in the number of support staff hours that are available in the bungalows. This has enabled service users to receive more support in the bungalows and with evening activities outside the CARE Wiltshire site. On occasions, a staff member may leave a bungalow and the service users are by themselves for a period of time. Staff members are contactable in one of the other bungalows. This may be an appropriate arrangement, however a requirement has been identified at the two previous inspections for individual risk assessments to be carried out in respect of the ability of service users to manage without a staff member on the premises. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 19 The manager said that these assessments had not been undertaken for all service users. At the last inspection a timescale of 31 May 2005 had been agreed for their completion. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 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 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 There has been a lack of attention to regulatory responsibilities, some of which concern the safety of service users EVIDENCE: Two requirements from the last inspection have not been met. These concern: • • The safety of service users who remain in their bungalow without a staff member present. The recording of fire alarm tests in the fire log book. There was no record of a fire alarm test having taken place since 21 July 2005. Immediate requirement notices were issued in respect of these outstanding matters. There has been a delay in notifying the Commission of allegations of physical abuse involving service users. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 21 It is recommended that the management and reporting arrangements are reviewed to ensure that the above matters are always dealt with in a timely manner. CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 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 X X X X Standard No 22 23 Score 3 1 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X X LIFESTYLES Standard No Score 11 X 12 3 13 X 14 X 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 CARE Rowde Score 3 X X X Standard No 37 38 39 40 41 42 43 Score 2 X X X X X X DS0000028267.V254162.R01.S.doc Version 5.0 Page 23 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 YA22 Regulation 22 Requirement Service users must receive accurate information about how to contact the Commission for Social Care Inspection. This will need to be included in the written complaints procedures The Commission must be notified, without delay, of any event in the care home which adversely affects the well-being or safety of any service user The registered person must ensure that an assessment is undertaken of the safety and ability of service users to manage on their own without a staff member present in the bungalow (this requirement is outstanding from the last inspection) The registered person must ensure that tests of the fire alarm system are carried out at least weekly and a record kept in the home’s fire log book (this requirement is outstanding from the last inspection) Timescale for action 31/10/05 2 YA23 37 16/09/05 3 YA32 18 30/09/05 4 YA42 23 16/09/05 CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 24 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 YA6 Good Practice Recommendations That timescales and the service users’ progress with achieving their objectives are more clearly identified within the action plans (this recommendation is brought forward from the previous inspection) That the contents of the policy file are reviewed in order to ensure that only the appropriate and up to date guidance on abuse is included That the management and reporting arrangements are reviewed to ensure that inspection requirements and Regulation 37 notifications are always dealt with in a timely manner 2 3 YA23 YA37 CARE Rowde DS0000028267.V254162.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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