Inspection on 24/05/07 for Drayton Road (14)

This inspection was carried out on 24th May 2007.

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 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

Drayton Road (14) 07/05/09

Drayton Road (14) 09/02/06

Drayton Road (14) 13/09/04

Drayton Road (14) 13/04/04

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

CARE HOME ADULTS 18-65 Drayton Road (14) Newton Longville Bucks MK17 0BJ Lead Inspector Chris Schwarz Unannounced Inspection 24th May 2007 11:45 Drayton Road (14) DS0000023070.V330915.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 Drayton Road (14) DS0000023070.V330915.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. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Drayton Road (14) Address Newton Longville Bucks MK17 0BJ 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) 01908 649592 01908 649592 N/A Turnstone Support Limited Mrs Lindsey Jane Wooldridge Care Home 3 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 people with a learning disabilities and/or a physical disability Date of last inspection 9th February 2006 Brief Description of the Service: 14 Drayton Road is a care home providing personal care and accommodation for three younger people with learning and physical disabilities. The home is run by Turnstone Support Ltd and is situated in Newton Longville, which is a small village on the edge of the market town of Bletchley in Buckinghamshire. The home is centrally located within the village. Although village amenities are limited, the home is close to them and makes full use of the facilities. Bletchley and the new town of Milton Keynes provide the home with a wider range of amenities. Both towns are within a short journey of the home. 14 Drayton Road is a large, detached bungalow, which has been well designed and refurbished to meet the needs of the three service users who reside there. All bedrooms provide single room accommodation but do not have adjoining en-suite facilities. As the home is a bungalow, there is no passenger lift but aids and adaptations are fitted at key assessed points. The home has a drive that is able to accommodate three vehicles and there is a small garden to the rear and side of the building. Fees for the service are £2022 per week. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced key inspection was conducted over the course of a day and covered all of the key National Minimum Standards for younger adults. Prior to the visit, a questionnaire was sent to the acting manager for completion alongside comment cards for distribution to service users, relatives and visiting professionals. Any replies that were received have helped to form judgements about the service and reflected overall satisfaction with standards of care at the home. Individual comments are contained under the relevant sections of the report. The inspection consisted of discussion with the acting manager and other staff, opportunities to meet with service users, examination of some of the home’s required records, observation of practice and a tour of the premises. A key theme of the visit was how effectively the service meets needs arising from equality and diversity. Feedback on the inspection findings and areas needing improvement was given to the acting manager at the end of the inspection. The acting manager, staff and service users are thanked for their co-operation and hospitality during this unannounced visit. What the service does well: Prospective service users are thoroughly assessed prior to admission, have the necessary information about the home and are given opportunity to visit beforehand to ensure it meets their needs. Effective and detailed care plans are in place which adequately document service users’ needs and how these are to be met, within a risk assessment framework. Service users have a varied and active lifestyle which reflects their interests, provides them with nourishing meals and offers them opportunity to try new experiences and have contact with family, friends and the community. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. Complaints and adult protection are effectively managed to listen to views of people who live at the home or their representatives and reducing the risk of harm to them. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 6 The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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 Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 5. Quality in this outcome area is good. Prospective service users are thoroughly assessed prior to admission, have the necessary information about the home and are given opportunity to visit beforehand to ensure it meets their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There have not been any new admissions to the service since 2001. Previous inspections have concluded that admissions were handled effectively, with the needs of service users and their representatives taken into account. A Statement of Purpose and Service Users Guide were in place containing necessary information to help prospective service users and their families make a decision about coming to live at the home. Copies of contracts were found on service users’ files. There was evidence on files of staff explaining these important documents to service users. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9. Quality in this outcome area is good. Effective and detailed care plans are in place which adequately document service users’ needs and how these are to be met, within a risk assessment framework. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans were in place for each service user and permission was sought by staff before removing files from their rooms. The plans were found to be upto-date with information such as detailed assessments of care needs, a photograph of the person for easy identification, monthly summaries outlining areas like well being, activities undertaken and significant issues, pictorial records of the person’s likes and dislikes and a useful “important things about me” form. Last wishes were also documented. Documents were signed and dated and well presented. Files also contained various risk assessments to support daily living activities and access to the community. These too were up-to-date, signed and dated. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 10 The home manages service users’ money and keeps money secure with an individual record of transactions and receipts to verify expenditure. Each person keeps their money in their room and staff carry out a daily check of the balance, as observed during the inspection. Service user meetings have been held at the home on a regular basis with records kept of these and incorporating photographs to describe matters discussed. An advocate additionally has regular involvement at the home and holds meetings with service users on a quarterly basis. All those who completed comment cards were satisfied overall with standards of care and described a service which always or usually responds to the different needs of the people who live at Drayton Road. A relative said that his daughter’s needs “are covered comprehensively. She is obviously happy and well cared for.” Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17. Quality in this outcome area is good. Service users have a varied and active lifestyle which reflects their interests, provides them with nourishing meals and offers them opportunity to try new experiences and have contact with family, friends and the community. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users are involved in a number of activities and leisure pursuits and make good use of their local community. Activities such as horse riding, cookery sessions, aromatherapy, walks, going to church, shopping and going to the pub were enjoyed by service users and use was being made of a day service. Service users had recently returned from a holiday in Norfolk which had been successful. Staff described good relationships with neighbours who were supportive of the home and occasionally invited service users to their functions. People who completed comment cards indicated that service users are enabled to lead a life they choose and that contact with family and friends is supported by staff. One person considered that more activities needed to be available for service users, both inside and outside the home. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 12 Meals at the home were being well managed with menus organised a day in advance; on the day of the inspection service users had been provided lunch of their choice such as cheese on toast or sausages and beans. There was plenty of fresh fruit available in the kitchen and staff were observed offering drinks to service users. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20. Quality in this outcome area is good. The health and personal care needs of people living at the home are well met, promoting health and well-being and ensuring that they receive medication in a safe and consistent manner. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Care plans contained detailed and up-to-date information regarding each person’s specific care requirements and how these could be met. There was evidence of medication reviews taking place and records of seizures were being maintained, where appropriate. Medical appointments were noted in care files and on the whole showed regular access to community health care. Some overdue appointments for one service user needed to be pursued. There was evidence of working with other agencies such as the dietician and training on use of oral midazolam, for service users with epilepsy, had been provided by the local primary care trust. Seizure descriptions had been documented in care plan files. The home uses a monitored dose system of medication administration. Medication was being securely stored on the premises with records of medication administered to service users in good order with two staff signing Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 14 alongside each prescribed dose. Lists of their medication were contained within service users’ files and medication risk assessments were in place. Records of medication returned to the pharmacy were well maintained. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23. Quality in this outcome area is good. Complaints and adult protection are effectively managed to listen to views of people who live at the home or their representatives and reducing the risk of harm to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A complaints procedure was in place at the home and a log book set up to record any complaints made by or on behalf of service users. No fresh complaints were noted in the log book and the Commission is not aware of any issues raised by service users or their representatives. People responding via comment cards were aware of how to make a complaint. A Protection of Vulnerable Adults policy was in place and a copy of the local adult protection guidelines had been obtained from Social Services. Staff had attended adult protection training and were receiving annual updates. There had not been any adult protection issues that the Commission is aware of. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30. Quality in this outcome area is good. The home is clean, well decorated and adequately maintained, promoting a positive environment for the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home is located on one of the main routes into Newton Longville and is a detached bungalow. There is ramped access with grab rails from the small car park to the front door and once inside all accommodation is on level ground. There is a lounge/dining room overlooking the front garden and a good sized kitchen leading off it with access to the garden area. Each service user has their own good sized bedroom which had been decorated and arranged to individual taste and staff sought permission before permitting access to the rooms as part of the inspection process. There is a large bathroom with shower and toilet and a separate toilet next to it. The home does not have a bath. The office doubles as a staff sleeping in room and is centrally located in the building. There is a laundry area which was being kept clean and tidy and had sufficient equipment for the size and needs of the home. Cleaning products were kept locked away to prevent accidental injury or ingestion. The Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 17 acting manager reported good response from the provider organisation to maintenance issues with prompt attention given to any issues that had arisen so far, such as a faulty shower. Outside, there is parking for a small number of cars. The home was growing its own tomatoes and potatoes and staff were planning to extend the range to other vegetables. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35. Quality in this outcome area is good. The home provides staff cover to meet needs and undertakes thorough recruitment procedures, coupled with effective training to ensure staff have the right skills and competencies to support the people who live there. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Rotas showed that two staff are rostered to cover the home during the morning and afternoon/evening shifts with one person on a waking night shift plus another sleeping in. Staff on duty were observed to be respectful and gentle in their approach to service users and were mindful of safeguarding their privacy. The training files of two newer staff were looked at and showed that all mandatory training had been undertaken with additional courses such as communication and administration of oral midazolam to supplement their skills and knowledge. The provider organisation was described as having good training programmes and being responsive to the needs that individual homes may have. All but two of the staff team either had attained a National Vocational Qualification or were undertaking one at the time of the inspection. Staff described a well run home where there was a good sense of teamwork and said that there was good communication at the home. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 19 Some agency staff were being used to fill gaps on the rota, all supplied by the same agency in Milton Keynes. A profile for one agency worker was seen, which confirmed that the agency had undertaken checks on the person and confirming these to be satisfactory. There was no information about the other two agency workers although the acting manager said that she had seen personal documents for one of the workers but had been unable to copy them due to a problem at the time with the photocopier. Recruitment files of two new permanent staff were requested and only copies of their Criminal Records Bureau checks were available. Prior to the inspection a call had been made to the home to check the location of recruitment files and to ascertain who on the staff team would be able to give inspectors access. Drayton Road has a history of good recruitment practice and the inability to provide evidence for this inspection of satisfactory checks is viewed proportionately and not a cause of immediate concern. However, the acting manager should ensure that evidence of satisfactory checks is available before agency workers commence work at the home and have permanent staff recruitment files available for inspection when this has been requested. Feedback from people completing comment cards was good overall. A relative commented “I appreciate all that the staff do for my daughter. She is well cared for and very happy.” A care manager said “When I have contacted or visited the home, I have always received an appropriate response, staff seem to be willing to put themselves out above the call of duty.” One person who completed a comment card felt that staff could spend more one to one time with service users to help them get to know service users better. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42. Quality in this outcome area is good. The management and administration of the home promote continuity and quality of care for the people who live there and ensure that risk is safely managed to reduce the likelihood of injury or harm. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s registered manager was on maternity leave at the time of this inspection and due back to work in September this year. An acting manager was covering the home until the end of May before taking up a position elsewhere in the company. Arrangements had been made for another person to take on responsibility to be acting manager for the remainder of the maternity leave. There was evidence from reports that the provider visits the home on a regular basis to assess quality of care and these visits had taken place at varied times Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 21 of the day and were thorough in content. The acting manager was aware that a quality assurance audit was due to take place. Health and safety was being effectively managed with checks undertaken routinely of hot water temperatures, fridge and freezer temperatures, contents of the first aid box and the home’s vehicle. Fire safety precautions were well managed and emergency procedures were in place for events such as power cuts, gas leaks and flooding. The home had a current gas safety certificate and one for electrical hard wiring and portable electrical appliances had been checked in November 2006. Generic risk assessments were in place for various matters. Accidents were being recorded, clinical waste was being disposed of appropriately and quarterly checks were being made for visual hazards on the premises. Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 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 3 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 23 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. 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. Refer to Standard Good Practice Recommendations Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate Oxford Business Park South Cowley, Oxford OX4 2SU 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 © 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 Drayton Road (14) DS0000023070.V330915.R01.S.doc Version 5.2 Page 25 - 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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