Inspection on 09/02/06 for Drayton Road (14)

This inspection was carried out on 9th February 2006.

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

The inspector 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) 24/05/07

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 Mr Rob Smith Unannounced Inspection 9 February 2006 12.00p th Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 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 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.V274426.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 3 people with a learning disabilities and/or a physical disability Date of last inspection 27th May 2005 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. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection. The inspection took place between 12.00 and 2.00 p.m. and comprised discussion with staff on duty, examination of a range of key records and a check of the physical environment. Due to the impact of their disability direct communication with service users to gain their views was difficult, however observation of their behaviour and interaction with staff was taken into account in drawing up this report. The registered manager for the home was not on duty at the time of this inspection but information contained in a pre-inspection pro-forma and selfassessment form recently completed by the manager were taken into account in drawing up this report. What the service does well: 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. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 6 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.V274426.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): As no new admissions had been made to the home since the last inspection, and as this set of standards was judged as being fully met at that time, no further reassessment was undertaken on this occasion. EVIDENCE: Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8 The home had very good structure of individual planning aimed at ensuring service users’ needs were regularly assessed and reviewed. Service users were enabled as far as possible to have input into their care planning and into the overall running of the home (Stds 7 & 8) EVIDENCE: Two service user files were looked at and contained a very impressive range of up to date planning and review documentation that clearly outlined service user needs and how they were going to be met in the home. The planning was, as far as possible, structured in a service user-centred way, focusing on their determined wishes and preferences. These findings confirmed the similarly positive judgement on care planning noted at the last inspection. The care planning documentation was supported by a range of more specific information, for example on activities undertaken, health assessments and records of appointments, that provided good evidence of care plans actually being carried out in practice. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 9 The views of service users were taken into account in the drawing up of care plans to make them person-centred. Staff explained that wherever possible the expressed opinions of service users were sought but that often staff were dependent on interpretations of behaviours or reactions to determine service user wishes and preferences. Service users were also encouraged to contribute ideas towards the running of the home via regular house meetings in which they were supported by the input of external advocacy services. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11,12,13 The home worked hard to provide regular opportunities for service users to develop skills and enjoy new experiences through planned recreational activities and involvement in the local community (Stds 11,12,13) EVIDENCE: Service user records, information on notice boards and discussion with staff confirmed that the team actively sought opportunities for service users to challenge and develop their abilities in a range of creative and recreational settings. One service user was attending a weekly cookery skills class on the day of this visit; other activities included swimming, regular use of a sensory room facility, horse riding, as well as trips out to do shopping etc. It appeared that activities were planned very much on an individual basis with little if any current use of more traditional day centre programmes. The home was said by staff to be well supported by the local community with involvement by service users in local community events and activities encouraged. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,20 The home provided very good levels of monitoring and support of service users health care needs. Medication was safely managed. EVIDENCE: Service user files contained ample evidence of the satisfactory meeting of services users health care needs. Care planning documentation clearly outlined general health care needs and, where relevant, more complex aspects of medication and related health care tasks. The files also contained evidence of attendance for regular health checks and well woman screening and good liaison with health care professionals supporting service users in the home. These included inputs from the likes of speech therapists and behaviour management experts, alongside more specifically medical input from GPs consultants etc over medication regimes. The home had received a recent recorded compliment from the local dental practice, praising them for the work they did in promoting one service user’s dental health. Medication administration records and related information confirmed medication was being ordered, stored, administered and monitored effectively. Staff training records provided by the manager indicated staff were in receipt of up to date medication training and it was noted that further training was Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 12 planned to cover staff administering a new epilepsy related oral medication that they had hitherto not had permission to administer. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 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 the following standard(s): 22 The home had effective complaints procedures in place. EVIDENCE: The home had clear procedures in place for the management of formal and informal complaints by service users and other interested parties. The relevant file, which now contained a new format for recording complaints and their outcomes, showed there had a been a pattern of recent lower level concerns raised by a relative of a resident. The records showed these had been dealt with appropriately and efficiently, involving other agencies as and when appropriate. Alongside the complaints it was also good to note the records of recent compliments being maintained, which contained positive feedback from a relative and a health professional about the quality of care in the home. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 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 the following standard(s): 24,25,26,27,28,30 The home provided a good quality and well-maintained physical environment that met the needs of service users (Overall judgement covering all the standards inspected) EVIDENCE: Previous inspections have confirmed the overall quality of the design and equipping of the home. This visit involved brief scrutiny of the bedrooms and communal areas of the home. These were seen to be in good physical condition and decorated to a good standard. Service user bedrooms were clean, tidy and suitably furnished and personalised with service users’ own possessions. Bathroom and toilet areas were clean, hygienic and odour free. Systems were in place for identifying any faults or repairs required to the equipment and/or fabric of the building. Some repeated problems had been experienced with the operating of the shower in the bathroom. This was being pursued by staff in the home. Good attention was paid to the safety of the environment and no obvious health and safety risks were noted during this visit. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 15 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33,35 Staffing levels were adequate to meet the needs of service users Staff training programmes were in place to ensure staff were able to meet the needs of services users appropriately. EVIDENCE: Two staff were on duty at the time of this inspection and scrutiny of the rota and discussion with staff confirmed this was the typical level of day time staffing cover with night cover being provided by one waking and one sleepingin staff member. Staff on duty felt the current level of cover was satisfactory to meet the care and recreational needs of services users and that any occasions where two staff were needed to care for one service user could be organised so as not to impact on the care and supervision of other service users. Information received from the manager indicated that four staff had left the permanent team of the home since the last inspection. Recruitment had been undertaken and only a small number of hours were now vacant. There was currently regular use of relief or agency staffing to cover some of the shortfall. Rota records confirmed that where agency staff were used they tended to be the same consistent people so as to avoid undue disruption to service users. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 16 Written information received from the manager, feedback from staff and observation of information on upcoming training confirmed that Turnstone ensured staff received regular training in all key areas of practice that was regularly updated and monitored by the manager of the home. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 The home was well organised and run to ensure the meeting of service users needs was paramount Good systems were in place for external monitoring of the home Good attention was paid to ensuring the health and safety of staff and service users. EVIDENCE: Scrutiny of the various systems put in place for the day to day running of the home confirmed this was a well run establishment with staff clear about the primary focus on service users’ needs. This judgement was based on the quality of individual service user records and care planning, the effective recording of day to day events, the quality of communication between staff members and the prompt attention paid to arising concerns or developments whether to do with service users or, for example, the quality of the physical environment. The staff team was well organised and well supported through training provision. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 18 Turnstone had a very thorough approach to external monitoring of the service. Regular monthly monitoring visits were undertaken by the organisation with detailed reports subsequently produced and copied to CSCI. The inspector was aware of further planned developments to quality monitoring that would seek to more fully integrate the views of service users in those quality assessments. These developments will be followed up in more detail at subsequent inspections. Records in the home provided evidence of good attention to health and safety matters. Fire safety was well monitored, with up to date risk assessments in place and regular checking of alarm systems and fire fighting equipment. Records were maintained of fridge and freezer temperatures and regular probe testing of meal temperatures was undertaken. Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 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 Standard No Score 1 X 2 X 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 3 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X 3 X 3 X X 3 X Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 20 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. Refer to Standard Good Practice Recommendations Drayton Road (14) DS0000023070.V274426.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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. 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