CARE HOME ADULTS 18-65
Fch - Southbrook Road, 3/4 3/4 Southbrook Road Rugby Warwickshire CV22 5NS Lead Inspector
Sheila Briddick Unannounced Inspection 23rd November 2005 09:00 Fch - Southbrook Road, 3/4 DS0000004325.V268569.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 Fch - Southbrook Road, 3/4 DS0000004325.V268569.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. Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Fch - Southbrook Road, 3/4 Address 3/4 Southbrook Road Rugby Warwickshire CV22 5NS 01788 816928 01788 816928 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) FCH - Housing and Care Mrs Lydia Shallcross Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 6th June 2005 Brief Description of the Service: 3/4 Southbrook Road is a registered care home for six younger adults with learning disability. FCH Housing and Care, (FCH), provides 24 hour care and support for the service users living in the home. The home provides two separate living accommodations each providing a living environment for three service users. The living accommodation at 3 Southbrook includes a lounge, with dining area, kitchen, bathroom and three individual bedrooms. Living accommodation at 4 Southbrook includes a lounge, kitchen with dining area, bathroom and three bedrooms, one of which is situated on the ground floor and has an en-suite facility. There is a shared laundry area connecting the two houses. The service is situated on the outskirts of Rugby town centre and close to a small shopping precinct, and other local facilities. There is a parking area to the front of the property and a large landscaped, accessible shared garden to the rear of both houses. Access can be gained to each house independently and there is third entrance for staff coming on duty. Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 23rd November 2005 between the hours of 9 a.m. and 12:30 p.m. During this time the inspector had the opportunity to meet with the residents, up 30 interactions between them and the people of caring for them, tour the home and examine documents relating to the residents and the management of the home. Two members of staff were involved in the inspection process and their views are included in this report. What the service does well: What has improved since the last inspection?
There is now a care planning system in place that clearly identifies the assessed needs and personal goals of each individual with monitoring system in place to evidence the ongoing development of service users. At the time of the inspection visit refurbishment was taking place in the environment, which included kitchen areas. Appropriate provision was being made to provide lower-level working services to enable people who are wheelchair users to participate fully in kitchen activities. Staff spoken with felt that training opportunity to meet individual and specific needs had increased and records
Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 6 show that the team has taken advantage of this increase in training opportunity. The staff team is now becoming more established and people spoken with felt that as a direct result communication between the team was much improved. Family members are getting feedback from the manager of action taken by her to ensure they can access a copy of inspection reports for the home. Fire Safety equipment in the home is easily accessible in the case of an emergency. 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. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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 Fch - Southbrook Road, 3/4 DS0000004325.V268569.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): There have been no new service users coming to live in this home since the last inspection visit therefore these standards were not assessed on this occasion. EVIDENCE: Fch - Southbrook Road, 3/4 DS0000004325.V268569.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 and 9. There is a clear and consistent care planning system in place, this is providing staff with the information they need to satisfactorily meet service user needs. The systems for service user consultation are good with a variety of evidence that indicates service users views are both sought and acted upon. There is significant evidence of service users being supported to take risks as part of an independent lifestyle. EVIDENCE: Two care plans was seen at this visit, both were fully completed and very specific with the information necessary for staff to follow when meeting needs. There was evidence of service user’s views be included in care plan programmes, with service uses choosing their photograph on the front of their care plan and in one instance a service user had described their likes and dislikes and these words were included in the care plan. There is an established system in place for key workers and service users to meet regularly to discuss care plan progress and key workers complete a report of the activities each week that have taken place to meet individual needs. The manager monitors both key worker meeting and activity documents on a regular basis.
Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 10 There is a variety of communication aids being used in the home to enable service users to make decisions and this includes use of makaton signing, pictures and photographs. Digital cameras have been purchased and are taken everywhere with service users to record activities which are then included inhouse meeting records and care planning records. House meeting records are in symbol and photographic format and demonstrate the commitment of staff in ensuring that service users have the information, assistance and support they need to make decisions about their lives. Services user’s views have been sought in the Development Plan for the service next year, (2005 –2006), and their views taken on board and this includes developing a part of the garden area into a vegetable patch. Care plans seen have identified possible risks to service users in lifestyle activities and programs are in place to offer appropriate support that will maintain independence safely. There is evidence of the staff working closely with psychologists in identifying care plan programmes to meet specific needs. There is no written procedure for staff to follow when responding promptly to unexplained absences by service users although staff spoken with were very aware of service users whereabouts and daily routines. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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): 12,13, 16 and 17 Links with the community are good and support and enrich service users social and educational opportunities. Service user’s rights are being respected and their responsibilities recognised in their daily lives through effective care planning. Sufficient funds are available to meet the dietary needs of the people living in the home. EVIDENCE: At the time of this visit service users were getting ready to go to work placement activities, attending day services and planning community activities. This included work placement opportunity at a local cafe, shopping and visiting the service user working in the café. The service user talked to the inspector about people coming to visit them when they were at work that morning and they were looking forward to this. Day care access is reviewed on a regular basis and this includes when people grow older and desire to reduce the number of days they access the day centre. There is significant evidence of the staff team working closely with day service staff and college tutors in working together to achieve the aims and expectations of each individual service user. College tutors attend key worker meetings with the service user in the home. Access to facilities in the community is good with service users being able to attend their local church, shops, health care facilities, leisure and
Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 12 social centres. The manager regularly monitors the record of weekly activities of service users as part of ensuring aims and objectives are being met. The support service users need to maintain family links and friendships, inside and outside of the home, is clearly identified on their care plan. There is evidence in the home from photographs, diary entries and letters from family members of their involvement in activities and lifestyle of the people living in the home. Service users can access all shared areas of the home and were seen to do so freely. Staff were observed to knock before entering service user’s bedrooms and respected their privacy by not going into their bedrooms if the service user was not at home. Staff spoken with said that, each service user has their own room and is allowed to spend as much time there as they wish -- their privacy is well respected. The provider has recently reviewed the household budgets for the home and forwarded a copy of the cost of breakdown budget areas to the Commission for Social Care Inspection. This identified that sufficient funds are available to meet specific needs. Further support for individual needs is being sought from a benefits advisory service. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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 20 Personal support in this home is offered in such a way as to promote and protect service user’s privacy, dignity and independence. EVIDENCE: Care plans clearly identify the personal support needs of service users, this includes information regarding their personal choice when having their needs met. Staff spoken with had a clear understanding of the individual needs of service users and this was further demonstrated by observation of their care practice. There is clear evidence of the home working closely with physiotherapists, occupational therapist and speech therapist in agreeing care plan programmes to meet needs. This includes mobility programs and programs for eating and drinking. Risk assessments are in place for these activities although risk assessments necessary for safe eating could be more robust safe to ensure staff have sufficient and precise information regarding size and consistency of food. Care pans seen reflected up to date information regarding the medication needs of service users. Health Action planning is taking place with the support of Community Learning Disability Nurses. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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): 23 Care plan programmes are protecting people from harm or possible abuse. EVIDENCE: The support of psychology services is being sought in agreeing care plan programmes to meet specific needs. The psychologist will be attending a meeting with staff to agree and develop written guidelines for them to follow when meeting specific needs. Staff working in the home have attended training in the Protection of Vulnerable Adults. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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): 30 Progress continues in ensuring that infection control in the home can be managed effectively. EVIDENCE: Written instruction is clearly visible for staff in procedures they are to follow when cleaning mops, buckets and rubber gloves. The Macerator machine has now been removed from the care home. Arrangements are in place for refurbishment of both bathrooms to be completed by March 2006, this will include replacing existing floor covering to ensure that effective cleaning can take place. Fch - Southbrook Road, 3/4 DS0000004325.V268569.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): 35 The people living in this home can be sure that their needs are understood and being met by appropriately trained and competent staff. EVIDENCE: Staff training records in the home and on one staff file examined show that training has been accessed in the last twelve months in areas necessary to meet the collective and specific needs of the people living in the home. This has included Dementia Care, Principles of Care Practice, Protection of Vulnerable Adults, Infection Control, Dying and Bereavement and Equality and Diversity. There continues to be an active NVQ programme in place and staff are completing Learning Disability Award Framework training. Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 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 The manager has a clear development plan and vision for the home, in which she has involved service users and staff. EVIDENCE: The manager has completed her NVQ Level 4 in Management and is now working towards the Registered Manager’s Award, which is expected to be completed in the Spring 2006. During the inspection process the manager was able to describe the procedures in place to ensure the home is meeting the aims and objectives of the people living there and the service provision. This includes, regular and consistent monitoring of care plans, seeking the views of service users and involving them in development of the service, accessing the support and guidance of other professionals in care and actively implementing care plan programmes recommended by these professionals, including Learning Disability Nurses, Psychologists and Speech Therapists. The manager was seen to have a good working relationship with service users and staff.
Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 18 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 X X X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 4 X 2 X Standard No 24 25 26 27 28 29 30
STAFFING Score X X X X X X 2 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Fch - Southbrook Road, 3/4 Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X X X X X X DS0000004325.V268569.R01.S.doc Version 5.0 Page 19 Yes. 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 YA9 Regulation 13 Requirement Timescale for action 15/12/05 2. YA18 13 3. YA23 13 10. YA30 23 The registered manager must develop a written procedure for staff to follow in the event of a service user being missing from the home. Written guidelines for staff to 15/12/05 follow when supporting service users with eating food must be specific in describing the size and consistency of food to be given. The home must seek the 30/01/06 guidance and support of specialist services in the development of guidelines for staff to follow when supporting service users individual needs and agreed strategies recorded on the care plan. (Timescale of 30/08/05 unmet) The registered provider must 30/03/06 ensure that floor surfaces and walls in the home are readily cleanable, as part of infection control management in the home and this must include bathroom floors. (Timescale of 30/09/05 unmet.) Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 20 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 YA6 Good Practice Recommendations It is recommended that the manager acknowledges their reviewing of keyworker meetings that take place and records any action taken be her. Fch - Southbrook Road, 3/4 DS0000004325.V268569.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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