Inspection on 09/08/05 for Curtis Street (87)

This inspection was carried out on 9th August 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Curtis Street (87) 18/05/07

Curtis Street (87) 27/02/06

Curtis Street (87) 17/02/05

Curtis Street (87) 03/09/04

Curtis Street (87) 05/01/04

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 Curtis Street (87) 87 Curtis Street Swindon Wiltshire SN1 5LR Lead Inspector Stuart Barnes Announced 9 August 2005 at 9.30am 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. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Curtis Street (87) Address 87 Curtis Street Swindon Wiltshire SN1 5LR 01793 420314 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) Community Access Network Mrs Tracey Lynne Parker Care Home 3 Category(ies) of LD Learning disability registration, with number of places Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The registered manager must work a minimum of 64 hours per 4 weeks in this home except on those occasions when they are absent due to sickness, training and annual leave. Date of last inspection 17 February 2005 Brief Description of the Service: It should be noticed that it is the custom and practise in this service to refer to service users or residents as tenants but in doing so the home recognises that those living at the home do not have full tenancy rights. Tenant is the preferred term of the people living and working at the the home as it is seen as more empowering and respectful. This report however will use the term service user to describe the people who receive care and accommodation. 87 Curtis Road is a care home that provides care and accomomodation for up to 3 people aged between 18 years and 65 years who have a learning disability and need support. Community Care Network known as C.A.N. run the home. The house is a small terraced house house located within a 5 minute walk of the centre of Swindon. It provides each service user with their own bedroom. Additonaly there is a shared lounge, dining area, conservatory/orangery, kitchen and bathroom. One bedroom is on the ground floor the other 2 are on the first floor. There is a rear courtyard with a small garden and car parking for 2 cars at the rear. The service replicates principles of ordinary living being a 2 storey terraced house similar to others in the road. It is typicaly staffed with one person on duty with additonal staff at busy times. At night there is no awake staff presence. Instead staff undertake to sleep at the home in rotation and are expected to meet any night time needs as they arise. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This focussed inspection was by appointment and it took 7 hours to complete. Twenty nine out of forty three national minimum standards were inspected. Time was also spent progressing the requirements and recommendations made at the previous inspection as well as spending time with the staff on duty, meeting all the users of the service to find out what they think and examining various case documentation. The accommodation was not inspected but most rooms were seen. The view of one relative was taken into account. This reduced inspection methodology takes into account that the Commission following the previous inspection categorised this service as a ‘green’ i.e. a care home providing good all-round service standards and not a cause for concern. This continues to be a service that meets or exceed the standards expected by the Commission. It is a care home that is good at what it does. What the service does well: What has improved since the last inspection? Aspects of quality assurance have improved. The company obtaining the ‘Investors in People’ accreditation evidences this. Information about the service is better formulated and it has been improved by some minor amendments to various documentation. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.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. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.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 Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.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) 1, 2 and 3 The company provides comprehensive information about the service that has both breadth and depth. It includes a good mix of text, pictures and audio and is user focussed This home continues to support and guide service users very effectively so that they can benefit from living at the home and access a range of work, leisure and health facilities. EVIDENCE: The service user guide and statement of purpose has been further improved since the last inspection and now includes information on audio tape. These documents describe the service provided, and terms and condition of residency, including house rules and expectations. They promote empowerment and dignity, choice and independence. Service users report that their needs are being met to their satisfaction. They also confirm they are active participants in key meetings about their needs; something that is strongly evidenced in various case documents and other paperwork. Staff appear passionate about the empowerment of service users. Examination of case files confirm that people living at the home are meeting challenges, making progress, coping well and benefiting from the service. For example one care manager reports progress in aspects of self care, another reports good progress with certain behaviours. There is evidence of progress at work and maintenance of beneficial family contact, in difficult circumstances. All service users have a detailed assessment and a comprehensive care plan, some of which integrated documentation. Service users confirm they are involved in important meetings about their needs. Restrictions (if any) on Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 9 choice, freedom, or facilities are transparent and case files show that they are explained and agreed. For example; service users must agree to share house hold tasks, not to smoke in bedrooms, must pay for any deliberate damage and have no overnight visitors without permission. Service users confirm that they are supported to access a full range of medical and community services – something observed during the inspection but also evidenced throughout in various documentation and confirmed by service users. It is evident that those working at the home will actively support service users to use advocates or will advocate for them, should the need arise. Care is taken to ensure the mix of service user is compatible. There is evidence of collaborative and systematic working with other key health/social care workers. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 These are areas where the service is achieving success and it reaches high standards. There is a good balance between the promotion of rights, responsibilities and promoting independence for the overall well being of the person and managing some occasional difficult challenges. EVIDENCE: Service users confirm that they are active participants in their support/care plans. A feature of the service is that people that live there can tell you what goals or outcomes they are trying to achieve. It was observed on this inspection (and on previous inspections) that support staff and service users talk about agreed aims and aspirations as a way of keeping motivated and on track. Plans are very detailed and service users sign them, which show they are active working tools for a purpose. Service users routinely give a verbatim account of current issues in narrative style to their key worker who records what is said. The aim is to reflect on progress more than problems and it is used to help people manage difficult emotions. These are then summarised weekly. Support plans link well with assessment documentation including risk assessments. Service users confirm that they take and make decisions about their lives. For example; each service users’ day activities vary enormously. They may be semi retired, to or undertaking paid work or voluntary work, or participants in a range of leisure Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 11 events and educational courses. All 3 service users said they had chosen their recent holiday destination and confirmed they help chose the weekly menu. There is evidence to show that service users can opt out as well as opt in. For example case notes show one person declined to go swimming. Another opted not to go to keep fit but chose instead to visit a friend. Another declined the offer of new carpet for quite a long period of time. Records show that so far in 2005 there have been 3 house meetings involving all service users and a couple of support staff. Items discussed typically were; planning festivities or outings, house rules, fire safety, personal safety (e.g. prevention of sun burn) and domestic issues. Case documentation shows and service users confirm that they get help to improve their communication skills and help with literacy skills. Checks were made on the way the service manages any monies handed over for safekeeping. The system is transparent. It includes double checking and reconciling each record at each shift change. Records seen appeared accurate and showed no unusual spending patterns or reasons for concerns. Risk is well managed and well documented. For example, case documents show identified hazards, likelihood of occurrence, any necessary corrective actions and periodic review dates for matters such as managing money, use of windows, safe bathing, ‘ home alone’ and fire safety. Attention is giving to the risk to each service users and to associated risks to others. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11, 12, 13, 14 15, 16 and 17 These are areas where the service is achieving success and reaching high standards; in some cases reaching a standard of excellence. EVIDENCE: Service users report good satisfaction levels. Placement reviews indicate ‘year on year’ progress in many areas, such as with personal development, social skills and managing difficult feelings. For example documents report one person as making progress with their care of personal property including clothing, another reports improved arrangements for managing medication. Training for independence is integrated within personal responsibility programmes as well as part of routine daily living. For example records show when someones shoelace broke and they asked for a new one they were given £1 to go out and buy one for themselves from the nearby shop. Risk assessments link to personal development goals and personal aspirations. All service users are encouraged to use their daytime usefully and in a beneficial way. It was observed that staff work hard to keep people focussed and on track. This is typicallydone by using gently prompts, having discrete Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 13 chats and especially by use of praise, including written praise in daily diaries which service users read. The service is well placed for easy access to a whole range of leisure and education facilities. Service users confirm that they can and do access pubs, clubs, sports facilities, theme parks and civic amenities. One service user said he goes swimming, rides his bike, goes out for meals, has holidays abroad, and attends a local nightclub. Another said they tried a Turkish bath locally. One attends an art class. Two reported they regularly visit friends or family. A relative confirmed that they had no concerns about the service (other than it could do with some re decoration) and reported that in the time they have been visiting the service it has improved. The service user guide shows that friends and relatives are welcome to visit. Service users confirmed that this was so. It was observed that support staff know the names of each service user friends/relatives and that they take a genuine interest in them. It was also noted that support staff were observed to engage service users in mature, age appropriate, respectful and purposeful conversation. Two service users have been provided with front door keys. The other has declined the offer to have a front door key. Menus were seen. They show that breakfast is a free choice and the main meal is at night time, except at weekends. One service user has a different meal plan, which confirms that people are treated as individuals. Service users report that they choose the menu for one week in rotation and the person choosing also does the required shopping. Consequently menus are varied and reflect preferences. Comments from service users did not fully endorse the end product. One person said they are, “alright.” Another said, “not to bad – quite nice.” A relative reported that they were not aware of any concerns re meals and menus and that the service provides at least one cooked meal a day. Food stocks were checked and found to be adequate. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18 and 19 The service is good at meeting these standards. This is something that is acknowledged by service users, support staff, directors of the company and verified in case documentation. EVIDENCE: Service users praise the home for the quality of the support they receive. One person articulated this by saying, “if he was not living at the home he would be all messed up”. If help is needed with aspects of personal care such as grooming or what to wear it was observed that this is offered discretely in a low key and non-judgemental manner. Case files show that each service user is supported to access any required medical services including specialist services and for those who need it a medication review. Through informal information exchange support staff promote options for healthy living; typically this covers healthy eating, reduction of smoking and sensible drinking. Support staff show a good understanding of mood and emotional well being. They demonstrate that intuitively they are able to manage excess highs and lows and there are written reports that confirm support staff take forward any concerns in an appropriate and managed way. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not inspected on this occasion. It was however confirmed that no complaints have been received about the service since 22 March 2003. EVIDENCE: Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) None of these standard were inspected. However it was noted that since the last inspection a service user has been provided with a new carpet and a sofa has been replaced. One relative expressed the view that parts of the house would benefit from a ‘lick of paint’. The inspector has invited the company to budget plan some redecoration in the next 12 months. EVIDENCE: Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34 and 35 The service is providing staff in adequate numbers that are competent and caring and who are able to meet the needs of the users of the service. EVIDENCE: Company directors and the registered manager report that staff work well as a team and that they provide good standards of care. Service users praise the staff that work at the service. No one made any adverse comment about the support staff, manager or company. Staff demonstrate a vision and belief that accords with the service user guide and statement of purpose. Staff report good working relationships with each other. They confirm the manager makes them accountable for the work they do, including offering praise and encouragement. For a home of this size the company provide detailed policies and notes of guidance on issues that are relevant to the service. There has been some staff turnover with 4 people leaving in the past year. This is due in part to the recruitment of people at university or people accepting a position as a prelude to undertaking professional training in nursing or in one case not being successful at completing their probationary period. The channels of communication between support staff and management appear effective. They include regular team meetings (typically monthly) and regular ‘one to one’ supervision (typically 6/8 meetings annually). Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 18 The recruitment records of 2 staff were checked. These show that each completed an application form and it was supported by at least 2 written references that were satisfactory or better. Both had recent protection of vulnerable and criminal record checks in place along with required proof of identity and terms and condition of employment. Support staff confirm the availability of a range of relevant training. Records show that National Vocational Qualification Training is encouraged along with other statutory courses such as first aid, health and safety, basic food hygiene. Take up of National Vocational qualification is impressive and exceeds the current standard. Supervision records show good attention to concerns such as providing privacy, ensuring dignity, empowerment, communication, care planning and worker achievement. Team meetings typically cover various aspects such as service standards, policies, procedures, service user needs and team working. A feature of the staff team is that it is all female where as the user group is all male. Records show all staff have had a recent appraisal and there is a written training plan Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39, 40, 41, 42, 43 This continues to be a well run home that is achieving very good outcomes for service users that ensure there well being and safety EVIDENCE: The company achieved the ‘Investor in People’ accreditation in March 2005. Service users praise the home and describe a service that supports their needs. They report feeling safe and they describe a caring service. One service user compared it very favourable to a previous care environment. Support staff demonstrate an awareness of ensuring well being and general health and safety in the home and further a field. They show a good understanding of balancing opportunity with risk. They manage these into the service design. For example policies underpin the main aims of the service. Assessment, including assessment of risk and care planning is well documented. There is, for a such a small service, good attention to ensuring accountability, spot checking and obtaining confirmation from service users Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 20 what they think and noting it. Above all service users are active participants in their life planning and in key decisions that effect them. This is a service rarely complained about. It has a competent and experienced manager who is deemed as a fit person by the Commission to manage this home. There is an absence of any male staff working at the home. There is no evidence to indicate the home is not financial viable. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 4 4 x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 4 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 4 4 4 4 3 3 3 Standard No 31 32 33 34 35 36 Score 4 4 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Curtis Street (87) Score 4 4 3 x Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 3 3 DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 22 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation None 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. Refer to Standard YA33 Good Practice Recommendations It is recommended that consideration is given as to the need for the recruitment of any male staff. Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 23 Commission for Social Care Inspection Suite C, Avonbridge House Bath Road Chippenham Wiltshire 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. Extracts may not be used or reproduced without the express permission of CSCI Curtis Street (87) DD51_D01_S3234_87CURTIS STREET_V238868_090805_STAGE4.doc Version 1.40 Page 24 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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