CARE HOME ADULTS 18-65
Coriander Road Care Home 25 Coriander Road Bede Island Leicester Leicestershire LE2 7ER Lead Inspector
Kim Cowley Key Unannounced Inspection 19th April 2007 12:00 Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 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 Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 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. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Coriander Road Care Home Address 25 Coriander Road Bede Island Leicester Leicestershire LE2 7ER 0116 2991782 0116 2858697 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.macintyrecharity.org MacIntyre Care Vacant Post Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 20th April 2006 Brief Description of the Service: Coriander Road Care Home is situated close to Leicester City Centre and accommodates up to four younger adults who have learning disabilities. The property, which is owned by a housing association, consists of two adjoining houses. Each has two single bedrooms, a kitchen/dining room, a lounge, and a garden. The home is fully accessible to residents and is convenient for local transport networks. Fees at the home range from £803 to £1087 per week depending on care needs. No additional charges are made. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing information relating to the home. During the course of the inspection, which lasted five hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means the inspector looked at the care provided to all four residents living at the home; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as communal living areas. Other issues relating to the running of the home, including health and safety and management, were examined. The inspector also met two residents, the Acting Manager, a senior carer, and three other carers. Prior to the inspection, a pre-inspection report and a set of residents/visitors survey forms were sent to the home for completion and distribution. None of these were returned to CSCI. (See ‘What They Could Do Better’ on page 8.) What the service does well:
Coriander Road provides a good all round service for younger adults with learning difficulties. The home has a lively and purposeful atmosphere, and all residents interviewed or observed appeared content and settled. Residents are encouraged to live as independently as possible and make choices in every area of their lives. During the inspection many areas of good practice were identified. These included care plans, which are created using a ‘person centred’ approach. This means they are designed specifically for each resident and document their particular goals and aspirations. Photographs and pictures are used to make it easier for residents to understand what they are trying to achieve. Residents at the home live full and active lives. They take part in a range of educational and leisure pursuits that are appropriate for their age group, for example keep fit, art, music, beauty, and cookery classes. One resident had had a manicure she was pleased with and was proud to show the inspector her nails. Another resident has a part-time job. Residents are encouraged to eat healthily and staff put great emphasis on this. The Acting Manager said that ‘convenience’ foods are avoided because of the
Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 6 additives they contain which can adversely affect residents’ moods. The same applies to ‘junk’ foods, which residents only have as an occasional treat. The Acting Manager said that as a result of healthy eating two of the residents show signs that their health has improved. The home has an established staff team. This gives residents the opportunity to get to know staff and build relationships of trust with them. All staff on duty during the inspection were enthusiastic about their work and knowledgeable about the residents they care for. The home is well staffed at all times so residents can take part in both a one-to-one and group activities. What has improved since the last inspection? What they could do better:
Although the premises are mostly homely and personalised, some areas are in need of improvement. These are listed in the ‘Environment’ section of this report. An audit should be carried out of the premises, and an action plan drawn up to prioritise the improvement work that needs to be carried out. The home’s domestic washing machine and tumble drier have been breaking down which staff believe is due to overuse. There is also no sluice facility and staff have to use buckets for soiled laundry. This situation should be reviewed and consideration given to providing an industrial washing machine with an integral sluice facility. This will help to reduce the risk of cross-contamination in the laundry. The home is still without a Registered Manager and one should be put in place as soon as possible to meet Regulations and provide effective leadership for staff. The pre-inspection report and other documentation sent to the home prior to the inspection for completion/distribution should be actioned and the preinspection report submitted to CSCI. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 8 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 Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents’ needs are fully assessed prior to admission to ensure the home is suitable for them. This judgement has been made using available evidence including a visit to this service. (Standard 2 was inspected.) EVIDENCE: The present residents have been in the home since in opened in 1998. At the time they moved in social services and staff at the home assessed them and the records were kept. The Acting Manager said that if future residents are admitted the Owning Body’s assessment process will be used. This will help to ensure the home is suitable for a particular resident, and that staff can care for them properly. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Detailed care plans help staff to identify and meet residents’ needs. This judgement has been made using available evidence including a visit to this service. (Standards 6, 7 and 9 were inspected.) EVIDENCE: Care plans are detailed and comprehensive, and contain appropriate risk assessments. Residents’ needs are addressed in full, including their interests, activities, and quality of life. Care plans are divided into two sections: support plans which set out each resident’s daily routine, and behavioural support plans which contain strategies for managing challenging behaviour Staff use a ‘person centred’ approach when writing care plans. This enables care plans to be tailored to the individual resident, and reflect their particular goals and aspirations. Photographs and pictures are used, where appropriate, to make it easier for the resident to understand what they are trying to achieve. Care plans are written in the first person as the information comes directly from the resident in question. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 11 Staff are expected to regularly refer to care plans so they can keep up with each resident’s progress. They are also subject to continual review to reflect resident’s changing needs. Care plans inspected provided evidence of residents’ gaining new skill and increasing in independence during their time at the home. They also showed that residents are encouraged to make decisions about their daily lives, with alternatives offered and choices made being recorded. The Acting Manager said, We try and give residents as much choice as possible. They make their own choices, but we manage the range of choices they have. For example, we let them choose between a selection of outfits that are suitable for the weather, so they still have choice but don’t end up wearing something unsuitable.’ The Acting Manager also said that giving residents more control helps to improve their behaviour as they come to feel responsible for their own lifestyles. Residents are aware of their care plans and encouraged to look at them if they wish. All records inspected were well kept and organised, with information easily accessible. Information on residents is kept securely in accordance with the Data Protection Act. Residents are encouraged to take responsible risks and staff support them in this, offering them choices within acceptable parameters of safety. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Daily living and social activities enable residents to lead full lives and grow in independence. This judgement has been made using available evidence including a visit to this service. (Standards 12, 13, 15, 16 and 17 were inspected.) EVIDENCE: Residents daily logs indicated a range of activities on offer including trips to the pub and to local churches. During the inspection one resident left the home to complete a paper round with the support of a member of staff. Care plans indicated that residents are encouraged to live full and active lives, taking part in educational and leisure pursuits that are appropriate for their age group. Some residents attend a day centre where they take part in keep fit, art, music, beauty, and cookery classes. One residents had had a manicure she was pleased with and was proud to show the inspector her nails. Residents who do not attend day centres take part in the Owning Body’s ‘Life Long Learning’ programme. This consists of community activities supervised by staff on a one-to-one basis.
Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 13 Residents in the two homes socialise with each other on occasions when they get together for video and home made pizza evenings, barbecues, buffets, and music. The Acting Manager said relationships between staff and residents at the home and those in the local community are good. Many neighbours know the residents by name and chat to them when they go out. Care plans indicated that residents are encouraged and enabled to maintain contact with families and friends. Residents are encouraged to eat healthily and staff put great emphasis on this. The Acting Manager said that ‘convenience’ foods are avoided because of the additives they contain which can adversely affect residents’ moods. The same applies to ‘junk’ foods, which residents only have as an occasional treat. Snack food consists of fruit and cereal bars. One resident has her own fridge in the kitchen where her snack foods are kept. The Acting Manager said that as a result of healthy eating two of the residents show signs that their health has improved. There is a kitchen in each of the two homes. During the week residents have their main meal in the evening, and at weekends they have their main meal at midday. All the residents help to prepare their meals with staff supervision. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Residents’ personal and health care needs are met in the way they want by staff in the home. This judgement has been made using available evidence including a visit to this service. (Standards 18, 19 and 20 were inspected.) EVIDENCE: Care plans showed that careful consideration has been given to how best to meet residents’ personal health care needs. For example, the Owning Body has a policy on male carers attending to the personal care needs of female residents. If female residents do not want male carers in this instance they do not have to have them. And male carers only give personal care to female residents with the approval of one of the Owning Body’s senior managers. This helps to ensure that residents are safeguarded and male carers appropriately supervised and supported. Staff help residents to live as healthy lives as possible by ensuring their health care needs are met. ‘Health Action Plans’ document this process. A range of health care professionals provide services to residents at the home including GPs, consultants, speech and language therapists, dentists and opticians. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 15 Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. Staff know how to safeguard residents and help them express any concerns they might have. This judgement has been made using available evidence including a visit to this service. (Standards 22 and 23 were inspected.) EVIDENCE: The home’s complaints procedure is available in both a written and a pictorial format. Records are kept of all complaints made and staff also complain on behalf of residents, for example if college courses are cancelled. The Acting Manager said that all the current residents are able to let staff know if they are not happy about something, either verbally or by using body language. All staff are trained in safeguarding adults and know what to do if abuse is suspected. In discussion staff were knowledgeable about this area and aware of the home’s ‘Whistle Blowing’ procedure. Staff are also trained to respond appropriately to physical and verbal aggression, and in the use of restraint. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. Residents live in an environment that is comfortable and mostly well maintained, but in need of some redecoration and improvement. This judgement has been made using available evidence including a visit to this service. (Standards 24 and 30.) EVIDENCE: The property, which is owned by a housing association, consists of two adjoining houses. Male residents live in one side and females in the other, and only enter each other’s space by invitation. Each house two single bedrooms, a kitchen/dining room, a lounge, and a garden. Overall the premises are mostly homely and personalised, but some areas are in need of improvement: • The stairwell in the female residents’ side of the home is gloomy and consideration should be given to painting this area a lighter colour, and ensuring the lighting is suitably bright to reduce risk on the steep stairs. The carpets are also worn and should be replaced. The kitchen in the male residents’ side of the home has stained work surfaces and flooring and would benefit from refurbishment. The hallways should also be improved as they are in need of redecoration.
DS0000006391.V333735.R01.S.doc Version 5.2 Page 18 • Coriander Road Care Home • • • Throughout the home plaster has cracked on the walls and ceilings. This needs attention. Two residents’ bedrooms have tired décor and could do with redecoration. The garden could also do with some improvement, for example the repainting of fences. It is recommended that an audit is carried out of the premises and an action plan drawn up to prioritise any improvement work that needs to be carried out. Care staff are responsible for cleaning the home and all areas inspected were clean, tidy and fresh. The Acting Manager said staff carry out most of the cleaning while residents are out at days centres or asleep to minimise disruption. During the inspection it was noted that the home’s domestic washing machine and tumble drier break down repeatedly. Staff believe this is due to overuse. There is also no sluice facility and staff have to use buckets for soiled laundry. It is recommended that consideration is given to providing an industrial washing machine with an integral sluice facility. This will help to reduce the risk of cross-contamination in the laundry. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 19 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Friendly and professional staff meets residents’ needs. This judgement has been made using available evidence including a visit to this service. (Standards 32, 34 and 35.) EVIDENCE: The home is well staffed at all times. This enables staff to facilitate residents’ lifestyles, and provide both one-to-one and group care as appropriate. The staff team is established and those employed come from a wide range of backgrounds including social and health care settings. Turnover is low, which means residents have continuity of care. All staff on duty during the inspection were professional and appeared to have excellent relationships with the residents in the home and to be able to communicate with them effectively. The Owning Body oversees recruitment and good policies and procedures are in place to help safeguard residents. Staff files could not be inspected as they are kept at a different location, but the Acting Manager confirmed that no member of staff starts work in the home without a satisfactory CRB/POVA check and two references. Once in post staff have regular one-to-one supervision sessions. The Acting Manager said, ‘This has been shown to
Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 20 improve the performance of the whole staff team. It establishes our aims and objectives and helps us to provide an environment where the focus is on improving residents lives.’ All staff undertake a varied and comprehensive training programme, which helps them develop the skills they need to meet the needs of the residents in the home. All staff with less that two years prior relevant experience do the Owning Body’s induction and foundation training. NVQ training follows this. In addition there is a rolling programme of essential training courses including first aid, epilepsy, communication, and challenging behaviour. External courses in specialist areas, for example Makaton, are also available. Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 21 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. Residents live in a home that is running effectively but would benefit from the appointment of a Registered Manager. This judgement has been made using available evidence including a visit to this service. (Standards 37, 39 and 42.) EVIDENCE: The home is still without a Registered Manager and one should be put in place as soon as possible to meet Regulations and provide effective leadership for staff. The current Acting Manager has run the home successfully since he took up his post in January 2006. He is due to leave in the near future, and is to be replaced by a senior carer who has worked for the Owning Body for four years. The operation of the home is overseen by one of the Owning Body’s area manager who carries out monthly Regulation 26 visits. Records showed that residents’ views and their likes and dislike are central to the running of the home. As many of the residents are unable to give their views verbally, staff rely on their own observations, and on information
Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 22 collected from families, friends, and health and social care professionals. In this way staff determine how best to meet residents’ needs and ensure they have the best possible quality of life while living at Coriander Road. In addition the Owning Body’s ‘Standards and Excellence’ Department issues questionnaires to stakeholders to seek their views regarding the home. The results are then analysed and used to produce policies and bring about improvements where necessary. Records showed that the health, welfare and safety of residents and staff is a priority in the home. Appropriate checks and servicing of equipment has been carried out, as has consultation with the Fire Department and the home’s Environmental Health Officer. The Owning Body employ a senior health and safety representative who provides advice to staff at the home where necessary. (Please see also the ‘Environment’ section in this report.) Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 23 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 4 23 4 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 2 X 4 X X 3 X Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard YA24 YA30 Good Practice Recommendations An audit should be carried out of the premises and an action plan drawn up to prioritise any improvement work that needs to be carried out. Consideration should be giving to replacing the home’s domestic washing machine with an industrial version with an integral sluice facility. A Registered Manager should be put in place as soon as possible to meet Regulations and provide effective leadership for staff. 3 YA37 Coriander Road Care Home DS0000006391.V333735.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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