Inspection on 26/07/05 for Church Street Care Home

This inspection was carried out on 26th July 2005.

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

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

Other inspections for this house

Church Street Care Home 20/02/08

Church Street Care Home 08/08/07

Church Street Care Home 18/10/06

Church Street Care Home 15/03/05

Church Street Care Home 11/05/04

Church Street Care Home 23/01/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 53 Church Street 53 Church Street Eastwood Nottingham NG16 3HR Lead Inspector Joanna Carrington Unannounced 26/7/05 10.00am 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. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 53 Church Street Address 53 Church Street Eastwood Nottingham 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) 01773 787446 0115 9104267 NCHA Violet Priest CRH 5 Category(ies) of LD 5 registration, with number of places 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 15/03/05 Brief Description of the Service: 53 Church Street is a detached property standing in its own grounds close to the centre of Eastwood and its amenities. The home is registered to provide support and accommodation to five adults with a learning disability. One resident is due to be leaving the project. This will be the first person to leave the group since it opened 13 years ago. There is a large open plan dining room and living room and the kitchen is domestic in scale. There is no lift to the first floor, however there is a suitably adapted bathroom on the ground floor for wheelchair users. The home is a joint project between Nottinghamshire Healthcare Trust and Nottingham Community Housing Association. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over four hours on the 26th July 2005. This was the home’s first inspection for this financial / inspection year. The inspector was unable to speak with the people who live at this home due to their limited communication skills and understanding. Therefore, any judgements in this report are from observation and reading residents records and documents. Two residents files were looked at. A partial tour of the premises took place and two members of staff were spoken with. The manager Julia Watkinson was available throughout the inspection for discussion and feedback. Julia has recently been appointed as manager of the home and therefore it is required that an application is made for registration. What the service does well: What has improved since the last inspection? Some improvements have been made to the environment to make it safe. The cracked pavement at the front of the house has now been repaired and tiling in the kitchen has also been replaced. Some effort has been made to identify advocates to assist residents in accessing the complaints procedure. Unfortunately, attempts have been unsuccessful due to limited advocacy services in the area. However, a previous manager, who is now independent of Nottingham Community Housing Association, has volunteered to advocate on behalf of one resident who has no one else to represent him. Foodstuff stored in the fridge is now labelled correctly, which is important for promoting the health of residents. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 6 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. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) X None of these standards were assessed on this occasion. EVIDENCE: 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The assessed and changing needs of residents are well documented in individual care plans and staff are committed to promoting independence and assisting residents to make decisions and choices about their lives. EVIDENCE: Supports plans for two residents were seen and for both residents there were detailed information covering all aspects of personal care, health care and emotional, social and recreational support. Only current care plans are printed out and kept as a hard copy (while all information is recorded and stored electronically) and this information is well organised and accessible. Risk assessments identify any restrictions imposed or ways to promote independence by minimising risk and these are presented with their respective support plans. There was evidence that support plans are drawn up involving other specialist professionals and to ensure that plans are current there was evidence indicating that they are reviewed regularly. Staff spoken with demonstrated a commitment to promoting choice for residents and there are support plans in place, which identify how individual residents will express choice and make decisions. It is recommended that more reference is made in all support plans on how to promote choice. For example, assisting residents in selecting their own clothing. It is also 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 10 recommended that visual tools such as pictures and symbols are used to enable residents to make choices and to be involved in all aspects of life in the home. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 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) 16 Residents’ rights and responsibilities are recognised and respected. EVIDENCE: It was apparent from both observation and talking with staff that residents are treated with respect. Staff were observed interacting and engaging with residents, not just exclusively with each other. Housekeeping tasks that residents are responsible for within the home are clearly identified in the appropriate support plans. Residents do not have keys to their own bedrooms, which was an outstanding requirement at the last inspection. The manager explained how since then support plans have been devised highlighting how individuals’ right to privacy is safeguarded while residents do not have their own keys. It is recommended that in this support plan there is more emphasis on why residents do not / cannot have their own keys and how subsequently, can the security of residents’ belongings be maintained. This will need to be followed up at the next inspection. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 Residents’ personal support and health care needs are met and residents are protected by the home’s procedures for dealing with medicines. EVIDENCE: It is evident that support plans are drawn up with the involvement of other agencies. Advice is sought from the relevant specialist professionals such as speech and language therapists, psychologists and continence advisors to ensure that residents receive all of the necessary and appropriate care and support. There are separate appointment records kept for all the necessary routine health checks and there are good systems in place for the monitoring of specific health conditions. There are also support plans for promoting a healthy lifestyle. For example, going out for short walks. Individual’s daily records indicate that there is always flexibility with when residents can go to bed and what activities are on offer and participated in. Medication storage and administration records were looked at during the inspection and no issues of concern were identified. All instructions for the administration of medication are clear with a photo of each resident attached. There are good support plans in place stating under what circumstances can ‘when required’ (PRN) medication be administered. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 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 standard(s) 22 Further progress is required to enable residents to access the complaints procedure and for their views to be heard. EVIDENCE: Even though there is an adequate complaints procedure and that symbols are used to communicate the procedure to residents, at the last inspection the manager expressed concern that residents do not ever complain. Advocates were recommended. Unfortunately, the manager reports that there are currently no advocacy services available locally. However, a previous manager of the home, who no longer works for Nottingham Community Housing Association, has volunteered to advocate on behalf of one resident, who has nobody else to represent him and all other residents have family involvement. Therefore, if independent advocacy services cannot be accessed, then alternatively, it is recommended that the complaints procedure and its use is promoted to family and friends of residents. Staff should also be encouraged to assist residents in accessing the complaints procedure, so that any issues concerning residents are acted on and taken seriously. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 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 standard(s) 24, 26 and 28 Some progress has been made with improving the safety of the environment. However, refurbishment and maintenance work is still required around the home in order to provide comfortable and adequate shared space for residents and adequate facilities in bedrooms. EVIDENCE: Where there was a large crack in the concrete path to the front of the house this has now been repaired and made safe. The manager must also ensure that all parts of the home that residents have access to are free from hazards to their safety; a large old rug in the hallway was removed during the inspection as it is regarded to be a serious trip hazard. Cracked tiles around the sink in the kitchen have now been replaced. Since the last inspection an Environmental Health Officer has visited the home and has recommended that the whole kitchen be refurbished. According to previous inspection reports the home is awaiting a refurbishment, which will take into account the need for additional communal space for residents. Currently there is only one large dining and living area. This is not adequate for a group of residents that can present with challenging and intimidating behaviour. As one member of staff explained, for the quieter 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 15 residents there is nowhere else to go except their bedrooms. It is recommended, but only for the interim that the staff sleeping in room no longer in use, is furnished as a quiet room for residents and visitors. It must be noted that this cannot be a long-term solution as it discriminates against the resident who cannot get upstairs. The décor in the communal areas is now very much outdated and urgently needs attention. Re-plastering is required around the door of the downstairs bathroom and at the bottom of the stairs and the manager has already requested for this work to be done. The manager is also waiting for work to commence on the installation of double sockets in residents’ bedrooms. Individual support plans stating how one electric socket is adequate in meeting the specific needs of residents must be provided to the Commission for Social Care Inspection. Otherwise, given that this was an outstanding requirement at the last inspection, enforcement action will need to be considered. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 16 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) X None of these standards were assessed on this occasion. EVIDENCE: 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Most of the necessary procedures and tests are carried out to promote and protect the health, welfare and safety of residents. EVIDENCE: All opened food packaging in the fridge are now labelled correctly, which was identified as a requirement at the last inspection. Fridge and freezer temperatures are not being recorded daily, which is essential for ensuring food is stored at a safe temperature to avoid food poisoning and illness. The testing of gas and electrical systems and equipment are up to date and there is regular testing for Legionella. The manager has liaised with the local Fire and Rescue Service for advice on the security of fire doors at night, which is good practice. Weekly fire alarm tests and drills are up to date but weekly testing of door releases is also required, in accordance with Fire Precaution regulations. 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 18 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score 2 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 2 x 1 x x Standard No 11 12 13 14 15 16 17 x x x x x 2 x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 53 Church Street Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 20 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 24 Regulation 13(4)(a) Requirement Ensure that all parts of the home to which service users have access are so far, as reasonably practicable, free from hazards to their safety. Carry out intention to refurbish the home, without further delay, to ensure that the premises are suitable in meeting the needs of the service users and provide adequate private and communal space. Ensure that all parts of the home are reasonably decorated. Ensure that adequate equipment suitable to the needs of service users is provided. If support plans are not provided to the Commission for Social Care Inspection stating that one electric socket adequately meets the individual needs of service users and then double sockets must be provided within the set timescale. Otherwise, enforcement action will be considered. This requirement is outstanding (original timescale 31/05/04 not met) Ensure for protecting the health of service users that fridge and Timescale for action 31/08/05 2. 24 23(1)(a), 23(2)(e) 01/04/06 3. 4. 24 26 23(2)(d) 16(2)(c) 30/11/05 30/11/05 5. 42 12(1)(a) 31/08/05 Page 21 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 6. 42 23(4)(c) freezer temeratures are recorded daily as a necessary measure for the prevention of food poisoning and illness. Ensure that the equipment of all 31/08/05 fire safety equipment is carried out in accordance with fire precaution regulations. 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. 2. 3. Refer to Standard 7 7 16 Good Practice Recommendations It is recommended that promoting choice is referred to in all relevant support plans. It is recommended that visual tools/ referential communication is used within the home to enable participation and decision making. It is recommended that there is a support plan thats emphasis is on why residents do not have their own keys and how therefore their privacy and security of their belongings can be maintained. It is recommended that the use of the complaints procedure is promoted to family and friends of residents and that staff are encouraged to assist residents in accessing the complaints procedure. It is recommended, in line with Environmental Health that the kitchen is refurbished. 4. 22 5. 24 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 22 Commission for Social Care Inspection Edgeley House Tottle Road Nottingham NG2 1RT 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 53 Church Street CO3 C53 S8651 Church Street V240801 260705 Stage 4.doc Version 1.40 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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