CARE HOME ADULTS 18-65
Edgar Street Residential Care Home 3 Edgar Street Huncoat Accrington Lancashire BB5 6ND Lead Inspector
Mrs Julie Playfer Unannounced Inspection 5th October 2005 01:00 Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 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 Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 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. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Edgar Street Residential Care Home Address 3 Edgar Street Huncoat Accrington Lancashire BB5 6ND 01254 872119 01254 872119 adelepilk@aol.com 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) Dr Morgiana Muni Nazerali-Sunderji Miss Adele Pilkington Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The service must, at all times, employ a suitably qualified and experienced manager who is registered with the Commission 9th March 2005 Date of last inspection Brief Description of the Service: 3 Edgar Street is registered with the Commission for Social Care Inspection to provide personal care and accommodation for 6 adults with a learning disability aged 18 to 65 years. The home is semi-detached in a residential cul-de-sac. It is close to local amenities and within walking distance of public transport to the nearest large towns. The accommodation is provided on 2 floors. There is a lounge, conservatory, kitchen with dining area, and laundry facilities. All bedrooms provide single accommodation. The residents have access to and use all areas of the home, with supervision from staff if required. Outdoor space, with seating, is available. The philosophy of the home is one of promoting independence and enabling residents to make informed choices about how they live their lives. This is reflected in the individualistic manner in which daily support is planned and carried out and the number and variety of activities which the residents are supported to participate in. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over five and half hours on 5th October 2005. The previous inspection took place on 9th March 2005. No additional visits have been made to the home since the last inspection. On the day of inspection there were 6 residents accommodated at the home. Information was obtained from staff records, care records and policies and procedures. The inspector also spoke to the residents, the staff on duty and the registered manager. A partial tour of the premises was also undertaken, with the consent of the residents. What the service does well: What has improved since the last inspection?
Since the last inspection, the format of resident’s meetings had been changed, in response to the suggestions made by the residents; these were now known as “House Chats”. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 6 The complaints procedure had been updated to include the information that a complainant may go direct to the Commission for Social Care Inspection at any stage of the complaints process. The registered manager had developed a programme to ensure all staff received an appraisal of their job performance. 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. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 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 Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 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 the following standard(s): 1, 2, and 5 Residents were provided with useful and informative information about the services and facilities provided in the home. Resident’s needs were properly assessed and reviewed. EVIDENCE: Written information was available for residents in the form of a service users guide and statement of purpose. Both documents were presented in a suitable format and the service users guide had been distributed to all residents. However, the service users guide, which was under review, did not contain details about the relevant qualifications and experience of the registered persons and staff. Care records indicated that the residents’ needs had been assessed before admission by a social worker and the previous registered person. The assessments were kept under review by the current registered manager and the staff at the home. All assessments were completed in consultation with the residents and their next of kin, as appropriate. All residents had been issued with a contract/terms and conditions, which covered all the elements listed in the National Minimum Standards. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8 and 9 The care planning system fully addressed the needs of the residents and provided clear guidance to staff on how these needs were to be met. Relationships within the home were good. The established consultation arrangements ensured residents were able to participate in all aspects of life in the home. EVIDENCE: From the case files seen, it was evident each resident had a plan of care, based on the assessment of needs. The plans set out in detail the action needed to be taken by staff to ensure all needs were met. The care plans were supported by daily records of care and support. Any changes, issues or concerns were recorded along with all appointments, events and activities the residents had been involved with. All the residents spoken to were aware of their records and could access them at any time. The information in the daily records was collated into a monthly evaluation report, which included a review of the care plans and goal plans. An overall review was held once a year. The residents were fully involved in the review process and the development of their care plans.
Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 10 It was the practice of the home to support responsible risk taking and policies and procedures supported this approach. Detailed risk assessments and management strategies covered activities indoors and in the wider community and were included within the residents’ plans. During conversations with residents it was evident they were consulted both informally and formally and they were able to fully participate in life in the home. The format of resident’s meetings had changed since the last inspection, these were now known as “House Chats” in response to suggestions made by the residents. The residents set the agenda for the meetings and agreed on any action to be taken. The residents were supported with their financial affairs and detailed written records were maintained of all transactions. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16 and 17. Residents were provided with good opportunities to engage in a wide range of appropriate activities and were supported to use community facilities. The residents maintained strong links with their families, which were supported by the manager and staff. Arrangements were in place to ensure the residents participated in the life of the home and their rights were respected. EVIDENCE: The individual plans and care records demonstrated that residents had opportunities to maintain and develop practical life skills. For instance one resident had recently purchased her own train ticket over the telephone. Where necessary tasks had been broken down and achievable goals had been set. Residents had good access to an extensive range of recreational activities both inside and outside the home. Activities outside the home included; bowling, trips to the cinema, shopping, going out to restaurants and the use of leisure centres. The residents also attended the Hyndburn Neighbourhood Project, which was designed for all members of the local community.
Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 12 The residents pursued a number of occupational and educational activities. As such, one resident had three part time jobs, three people attended college and three people worked in a local charity shop. One person also attended a day centre. Staffing levels were reviewed at regular intervals, which enabled residents to pursue individual leisure interests. The residents were supported to maintain relationships with their families. One resident was away with her family at the time of the visit. Staff assisted with travel and other arrangements as necessary liaising with the family members. There were no restrictions placed on visiting. A relative and a social worker were visiting the home on the day of inspection. Both people were “very satisfied” with the care and support provided and commented on the warmth of the welcome in the home. The residents had unrestricted access to the home and grounds. The residents were also able to use their room at any time should they wish to spend some time in private. There were no set menus kept in the home. Each resident was allocated an amount of money to enable them to purchase their own shopping with support where needed. They were then assisted and supported to prepare their own meals individually. Guidance was provided by staff members to ensure a nutritious balanced diet was taken. The kitchen offered a homely environment to prepare and eat meals. The arrangements for choosing, purchasing and preparing food significantly promoted the residents’ rights to independence and choice. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 19 The residents’ healthcare needs were identified and met. Personal support was provided in a manner, which respected the residents’ rights to privacy and dignity. EVIDENCE: The residents’ individual care plans set out the personal support each resident required and provided details of how this support was to be delivered. Residents spoken to confirmed personal support was provided in private and their rights to privacy and dignity were respected. The registered manager and staff ensured consistency and continuity for residents by the use of a key worker system. The residents felt the staff were approachable and one person said “I always feel I can to talk to any of the staff”. Healthcare needs were appropriately assessed and were included in the care plan. There was evidence to indicate the residents had access to NHS services and the advice of specialist services had been sought as necessary. All residents were registered with a local General Practitioner. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 14 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 and 23 Systems were in place to ensure any concerns of residents would be acted upon. Policies and procedures and staff training were in place to respond to any allegations or suspicions of abuse. EVIDENCE: Both informal and formal arrangements were in place for the registered manager and staff listen to and act on the views and concerns of residents, by means of the “house chats” (resident’s meetings) and everyday conversation. The complaints procedure was included in the service users guide and was verbally explained to residents as necessary. The procedure had been updated since the last inspection to inform residents they may raise a complaint with the Commission at any point in the process. The home had received no complaints. A copy of “No Secrets in Lancashire” (The Joint Strategy for the Protection of Vulnerable Adults) was available, along with a specific procedure setting out the required response in the event of any allegations or suspicion of abuse. There was also a whistle-blowing policy available for staff. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 15 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 and 30 The residents were provided with a clean, safe and well-maintained home. EVIDENCE: The home is situated in a residential area in Huncoat. Accommodation is provided in 6 single rooms. Communal space is provided in a lounge, conservatory and kitchen with a dining area. There is a garden at the rear of the property, which the residents said they enjoyed using in fine weather. The furnishings and fittings were domestic in character and of a good quality throughout. At the time of the inspection, the premises were well maintained, comfortable, clean and free from offensive odours. There were established systems in place for the maintenance of the property and the renewal of fabric and decoration. The bedrooms had been decorated and furnished according to personal taste. Residents were able to bring in and purchase their own personal belongings, many of which were displayed in their rooms. Residents were able to use their rooms at any time, should they wish to spend time pursuing their own activities.
Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 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): 31, 32, 33, 34, 35 and 36 Staff were well trained and had access to a range of training opportunities, which gave them a good understanding of their role and the needs of the residents. EVIDENCE: Staff were issued with job descriptions, which set out their roles and responsibilities. The staff team were well-established and there had been no recruitment of new staff since the last inspection. Staffing levels were in line with previous guidance issued by the local authority and were regularly reviewed in line with any planned activities. Staff were offered a range of training opportunities and information was available in respect to the care and support of people with a learning disability. Each member of staff had a training assessment and profile and there was an overall training development plan for the staff team as a whole. At the time of inspection 100 of the care staff were qualified to NVQ level 2 or above. From discussions with staff during the inspection, it was evident they had a good understanding of the residents’ needs and knew the residents well. Staff referred to the residents in respectful terms and were observed to interact in a positive and pleasant way.
Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 17 The staff received regular supervision with the registered manager and there was a programme in place to carry out appraisals. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 18 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, 38, 39 and 41 The management approach promoted positive relationships between the staff and the residents and the overall atmosphere was open and friendly. The residents’ rights and interests were safeguarded by the home’s record keeping. EVIDENCE: The registered manager had the overall responsibility for the management of the home and had a job description, which reflected the aims and objectives of the home. The manager had completed NVQ level 4 in Management and was working towards the Registered Manager’s Award and NVQ level 4 in Care. The registered manager had also undertaken periodic training to update her knowledge and skills. The management approach was consultative and there were systems in place to consult both staff and residents. Relationships within the home were positive and staff spoke about the residents with respect. The registered manager had established systems to monitor the quality of the service, which included the distribution of satisfaction questionnaires. However,
Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 19 an annual development plan based on a cycle of planning, action and review had not been devised at the time of the inspection. All records seen were complete and up to date and kept in accordance with regulatory requirements. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 20 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 2 3 x x 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 3 3 x Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 4 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Edgar Street Residential Care Home Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 2 3 2 x 3 x x DS0000062212.V252869.R01.S.doc Version 5.0 Page 21 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 YA1 Regulation 4 Requirement The service users guide must contain details about the relevant qualifications about the registered provider, registered manager and staff. Timescale for action 30/11/05 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 YA37 YA39 Good Practice Recommendations It is recommended the registered manager achieve NVQ Level 4 in Care by 2005. It is recommended that the registered manager devise an annual development plan based on a systematic cycle of planning, action and review, reflecting aims and outcomes for the residents. Edgar Street Residential Care Home DS0000062212.V252869.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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