Inspection on 06/03/06 for Self Unlimited Rowde

This inspection was carried out on 6th March 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Self Unlimited Rowde 19/03/08

Self Unlimited Rowde 14/07/06

Self Unlimited Rowde 15/09/05

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 6th March 2006 01:45 CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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.V285704.R01.S.doc Version 5.1 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.V285704.R01.S.doc Version 5.1 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) Vacant Care Home 36 Category(ies) of Learning disability (36) registration, with number of places CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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. 15th September 2005 2. 3. 4. Date of last inspection Brief Description of the Service: CARE Rowde opened in March 1994 and is run by the registered charity, ‘Cottage and Rural Enterprises Ltd’ (C.A.R.E.). 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 who work 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. The care home establishment is registered in the name of CARE Rowde. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place between 1.45 pm and 6.25 pm. It focussed on the key standards that were not looked at during the previous inspection. Service users were met with in one of the bungalows and during a meeting that was attended by many of the service users who live on the site or were visiting for the day. There were meetings with three members of staff. CARE Rowde was without a registered manager at the time of this inspection. Christine Smith was managing the establishment and assisted during the inspection. There was a partial tour of one bungalow (Hawthorn). A pharmacy inspector looked at the medication arrangements, which included a visit to one of the other bungalows. Records were examined including risk assessments, quality assurance, staff training & recruitment and care assessments. What the service does well: What has improved since the last inspection? What they could do better: Service users need to be given better and up to date information about making a complaint and who they can contact outside CARE Rowde. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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.V285704.R01.S.doc Version 5.1 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.V285704.R01.S.doc Version 5.1 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 Prospective service users’ have their needs assessed and make a positive choice about moving into the home. EVIDENCE: One of the service users met with had moved into CARE Rowde since the last inspection. He said that he was pleased to have moved in and had previously visited for short stays and day activities. Christine Smith said that a second person had also moved in. This person had lived at another home run by C.A.R.E. and knew CARE Rowde well because he was already attending day services on the site. One of the new service user’s personal files was looked at. This included a copy of the community care assessment, an emergency information sheet and a self-assessment record, which included the service user’s own views. It is good practice for a service user to be able to contribute in this way. The parents had also provided a useful information sheet for staff, which gave another perspective. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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): 9 Service users receive support to participate in activities that involve a degree of risk. (Standards 6 and 7 were met at the last inspection). EVIDENCE: There is a Health & Safety Administrator who overviews the carrying out of all risk assessments on the site, including those relating to individual service users. ‘Home alone’ assessments have been completed, as discussed at previous inspections. This process has involved service users learning about what to do in particular situations. Records of other risk assessments were seen which concern subjects such as trips out and service users being able to access the main road. When meeting with staff members and service users in the bungalow, they spoke about activities that are currently taking place. One service user is practicing taking a bus journey to a local town, which they hope to be able to do independently. Other service users have been going to work placements by themselves for some time. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 10 A recommendation was made at the last inspection in connection with standard 6, ‘That timescales and the service users’ progress with achieving their objectives are more clearly identified within the action plans’. The action plans were not looked at on this occasion, although Christine Smith said that this was now happening. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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): 13 and 16 Service users participate in a good range of activities within the local site and the wider community. Their responsibilities and rights are well promoted. (Standards 12, 15 and 17 were met at the last inspection). EVIDENCE: The service users mix with people from the community who attend the on-site day facilities. A staff member said that service users continue to receive support with finding occupation in the community. During the inspection, a new job coach introduced himself at the service users’ meeting. Current occupations include one service user who works in a nearby pub and another who has a placement in a local school. The village of Rowde is within walking distance and there is a bus stop for Devizes, which service users use for many facilities. Service users can have keys to the front door of their bungalow and to their own rooms if they wished. Some rotas have been drawn up to help with a fair CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 12 distribution of domestic jobs. One service user was washing up after tea. The bungalow seen had a well enclosed and private pay phone facility. Service users have been given responsibility for running their own meeting and this took place before tea on the day of the inspection. A chairperson was chosen and one service user had responsibility for later representing the service users’ views at a staff meeting. During the meeting, service users talked about whether they would like a day out at Longleat in the near future and this was going to be arranged. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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): 19 and 20 Service users receive the support that they need with their healthcare. Residents are protected by the home’s training and procedures for the safe handling of medicines. (Standard 18 was met at the last inspection). EVIDENCE: The service users’ records showed details of GP and other health care professionals who they have contact with. Service users visit a dentist in Devizes. Christine Smith said that all the service users except one were registered with a local GP who conducts an annual health check with each person. A staff member said that service users receive good support from the GP and that there were no concerns about the health of the service users in the bungalow. The staff member also said that check ups and health appointments were recorded using forms, which for convenience sake, were completed in the central office block after returning home. These were not looked at during the inspection. Medication is received into the main house on a monthly basis and stored there. The bungalows only keep a week’s supply of prescribed medication. Lunchtime doses are given in the main house. Records of these transactions CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 14 are maintained. Medication administration records are provided by the pharmacy. All doses given are recorded and a record made of medication taken away for home visits or holidays. Homely remedies are given according to an approved list and information about their use shared between the main house and bungalows. Records are kept of residents visits to healthcare professionals and changes to prescribed medication. All support workers receive training in the handling of medicines from managers and an external agency. Residents can take responsibility for their own medicines after thorough risk assessments have been completed, but this is little used at present. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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 the following standard(s): These standards were not looked at on this occasion, other than to follow up the requirements that were made at the previous inspection. (Standard 22 was met at the last inspection and standard 23 was not met). EVIDENCE: Information about complaints is prominently displayed, although it was reported at the last inspection that the procedure available to service users did not always include contact details for the Commission. A requirement was made about this. This requirement has not been met as it was seen that the complaints procedure on a bungalow notice board had not been amended. This still referred to the National Care Standards Commission, with no address or telephone number included. Christine Smith responded to this at the time by including it as an item at the next managers’ meeting. Another requirement concerned the need for the Commission to be notified of particular events, without delay. Since the last inspection, the Commission has received written notification of certain incidents. Christine Smith said that these had been discussed with the manager of the local C.T.P.L.D., in order to ascertain whether a referral needed to be made under the protection of vulnerable adults procedure. Christine Smith was recommended to seek the involvement of a police officer from the vulnerable adults unit in the training that staff members receive in adult protection. This could be a useful addition to the training and guidance that the staff team already receive. It would also be an opportunity to consider in more details the type of allegations and incidents that are investigated through the vulnerable adults procedure. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 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): 30 Service users live in suitable and well maintained surroundings. (Standard 24 was met at the last inspection). EVIDENCE: The communal and domestic areas of the bungalow looked tidy and well furnished. Bedrooms were not seen on this occasion but all the bathrooms and toilets looked clean. A staff member said that the service users take some responsibility for the cleaning of the accommodation, with a staff member following up to ensure that this has been sufficient. Another staff member who was asked about training said that they have attended a course in infection control. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Service users benefit from the training that staff members receive and are protected by the recruitment procedures. (Standard 33 was almost met at the last inspection). EVIDENCE: There is a Training Officer who overviews the provision of courses and qualifications for all staff who work on the site. Learning Disability Award Framework accredited training is available to new staff members. This forms part of a written training programme for support workers, which sets outs the courses and subjects that are to be covered during the first three years of employment. NVQ at level 2 is planned to take place within year one. Several staff members have obtained an NVQ and others are working towards this. One staff member met with said that he was experiencing a delay in being able to start NVQ. He was hoping that this could be resolved as soon as possible so that he could make progress with obtaining qualifications. The training programme identifies some role specific subjects for staff who are in a management and supervisory position. An assistant manager confirmed that she had received statutory training and that she was due to start her NVQ at level 3. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 18 Staff members have individual employment files and a check was made of a new staff members’ recruitment documentation. The recruitment arrangements included the completion of an application form and a health questionnaire. There was some feedback from service users. Service users receive protection through the taking up of references regarding a prospective staff member’s character and work experience. A C.R.B. disclosure and POVA check had been issued before the new staff member started work. Christine Smith said that no staff member starts before their C.R.B. has been issued. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 19 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 and 42 Service users have good opportunities to contribute their views. Service users benefit from the arrangements that are made for health & safety. (Standard 37 was almost met at the last inspection). EVIDENCE: The meeting observed during the inspection was a good way in which the service users can agree their own agenda and talk about matters that affect them as a group. CARE Rowde had achieved the ‘Investors in People’ quality award. There are some well established meetings and systems in place by which service users can express their views about the services and facilities. Records relating to quality assurance were looked at. The Care Wiltshire Health & Safety Administrator has taken on responsibility for the introduction of a new system of quality assurance. This was a new role for the CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 20 Administrator, which she is now carrying out in conjunction with her health & safety responsibilities. The system has been produced by C.AR.E., for use in its own services. Service users and staff have completed questionnaires, with feedback obtained under headings such as Relationships, Activities and Choice. The results were being analysed and some action plans produced. The Health & Safety Administrator said that people were getting used to the system and it was still early days in its implementation. A health & safety policy was on display and CARE has produced comprehensive guidance about the implementation of health & safety related regulations. Time was spent with the Health & Safety Administrator, who spoke about the work she undertakes. This includes organising the servicing and maintenance contracts and bringing health & safety points to the managers’ meetings. A detailed list of such points had been drawn up for a meeting that took place on 16 January 2006. Examples of risk assessments were looked at. Assessments have been undertaken in respect of a range of environmental factors and employee activities. Other assessments seen concerned individual service users, including ‘home alone’ assessments. The Administrator said that these have now been completed for all service users. There had been a requirement at the last inspection that tests of the fire alarm system are carried out at least weekly and a record kept in the home’s fire log book. It was seen that tests have been recorded during the month although there had recently been a change in how this was done, which meant that the actual date of the test was not being entered. CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 21 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 Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 x 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 x 34 3 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x x x 3 x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x x x 3 x x 3 x CARE Rowde DS0000028267.V285704.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? Yes 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. (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 met in part since the last inspection – the actual dates on which the tests takes place needs to be recorded). Timescale for action 31/03/06 4. YA42 23 31/03/06 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 YA20 Good Practice Recommendations Written additions to the printed medication administration record should be signed, dated and checked by two DS0000028267.V285704.R01.S.doc Version 5.1 Page 23 CARE Rowde 2. 3. YA20 YA23 members of staff. The use of self medication, in whole or in part, could be explored with more of the residents. That the local vulnerable adults unit is contacted to see whether a police officer from the unit is available to talk to staff in the home. 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