Inspection on 14/02/06 for 58 Featherstone Road

This inspection was carried out on 14th February 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 11 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

58 Featherstone Road 11/07/07

58 Featherstone Road 18/07/06

58 Featherstone Road 04/08/05

58 Featherstone Road 09/03/05

58 Featherstone Road 07/10/04

58 Featherstone Road 12/03/04

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Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Featherstone Road, 58 Kings Heath Birmingham West Midlands B14 6BE Lead Inspector Kerry Coulter Unannounced Inspection 14th February 2006 12:50 Featherstone Road, 58 DS0000016715.V283608.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 Featherstone Road, 58 DS0000016715.V283608.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. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Featherstone Road, 58 Address Kings Heath Birmingham West Midlands B14 6BE 0121 444 6600 0121 443 5968 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) Sense West Mr Tom Harrison Care Home 4 Category(ies) of Learning disability (4), Sensory impairment (4) registration, with number of places Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years Date of last inspection 4th August 2005 Brief Description of the Service: Featherstone Road is a substantial detached home providing spacious accommodation and a specialist service for adults with sensory impairment and learning disabilities. The home is registered for four service users. The home is in a pleasant residential area of Kings Heath close to shops, churches, leisure facilities and Kings Heath Park. The home provides four single bedrooms, three on the first floor and one on the ground floor, and a small office / staff sleeping-in room. Two bedrooms have ensuite facilities and all are individualised to reflect service users personalities. There is a large bathroom upstairs and a toilet downstairs. The lounge is a good size and is comfortable and homely. The house has a large modern fitted kitchen and a dining room. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted by, one Inspector over one afternoon. This was the second of the statutory inspections for this home for 2005/2006 and not all of the National Minimum Standards were assessed. To get a full picture of the home it is advised to read this report in conjunction with the report from August 2005. At this inspection limited time was spent observing care practices, interactions and support from staff. The service users have some verbal communication but their ability to communicate to the Inspector their views of the home was limited. Service users were not at home for most of the inspection. A partial tour of the home was made. Service user care plans, risk assessments and some Health and Safety records were inspected. The Inspector had the opportunity to talk with the Practice Development Worker and the Manager. The Inspector did not have an opportunity to speak with relatives. What the service does well: What has improved since the last inspection? Training is being arranged for staff to ensure they can do their job and support people who live in the home safely. The home is working hard on improving care plans and risk assessments. These tell the staff how best to support people and they have lots of information in them. Risk assessments have been further developed to include regular review and commencement of detailing the level of risk. A Manager has been appointed for the home that can lead the staff and support them to meet the needs of service users. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 6 Some internal refurbishment of bathrooms has taken place making the environment a more pleasant place to live. It was previously required that a washing machine with a sluice cycle is installed, this has now been done. Recording of activities by staff 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. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 The Service User Guide provides most of the information needed to make an informed choice about services provided by the home. EVIDENCE: The Service User Guide was not observed at this inspection as the Manager said that the previous requirement to include details of any additional charges had not been completed. The Manager said he had been unsure of what was required. It was explained that this would include information such as charges for the home vehicle. Current Manager details also need to be added. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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, 9, 10 Care plans were detailed and specific but some information required review so the home can evidence that individual care needs are met. Strategies for managing risks were clearly identified and ensures that appropriate guidance is available to staff to enable them meet individual needs. EVIDENCE: Two care plans were sampled. These detailed information on both service users, including social skills, personal care, activities, likes and dislikes, guidelines and comprehensive health information. As previously required information on cultural needs had been added and behaviour management guidelines had been reviewed. Not all of the plans had been reviewed in the last six months although it was evident that the Practice Development Worker was in the process of reviewing one individuals care plan and had set a date for review of the other one. Evidence was available that other professionals are involved in the care of people who live at the home, for example the Speech and Language Therapist has completed assessments for eating and drinking. Service user records included individual risk assessments. All the activities that service users participate in have been assessed, these had all been recently Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 10 assessed by the Manager and Practice Development Worker. It would be beneficial if evidence of evaluation of the assessments was recorded on the review sheet in addition to the current system of staff just signing to say they had been reviewed. Work has also begun to highlight the level of risk. Discussion with the Manager indicates that this is to be further developed as Sense is in the process of revising the risk assessment format. Service users individual records are stored securely. Staff are mindful of issues discussed in the presence of service users, and were not observed to breach confidentiality. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 Adequate arrangements are in place so that service users experience a meaningful lifestyle. EVIDENCE: Sampled records, discussion with staff and observation of practice show that service users are encouraged to be as independent as possible, with opportunities available for personal development. Service users are encouraged to get involved in domestic activities, communication is facilitated by various means to include body language and objects of reference. The care plans contained a “Schedule of activity”. Activities on offer include music, daily living skills, dance, art and massage. On the day of the inspection service users were involved in activities in the community in both the morning and the afternoon. Activities on offer are varied and review meetings sampled show that new activities that service users might like to try are under consideration. Discussion with the Practice Development Worker (PDW) indicates that since the new manager has been in post activities are becoming more structured. Audits completed by the PDW show a satisfactory level of Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 12 activity is undertaken. Recording of activities by staff has improved since the last inspection. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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, 20 Systems are in place to manage service users personal care needs, ensuring they receive the care they require. The systems for the administration of medication are generally safe and only minor improvement is needed to fully meet the required standard. EVIDENCE: Care plans contain detailed information on the support needs of service users, and take into account gender care needs. Interactions between staff and service users were seen to be warm and friendly, and appropriately respectful. On arrival at the home the Inspector observed one service user being appropriately assisted to their room by staff to put back on a top they had removed. Service users were well dressed appropriately to their age and the weather. Medicines were seen to be stored appropriately in a secure location. A random audit of stocks held revealed no discrepancies, and there were no gaps on the administration record. A tube of topical cream were observed to be open, but no date of opening was recoded on the tube. This must be done and the cream discarded within 28 days of opening. This was a requirement of the last inspection. Some service users are prescribed medication to be taken on an ‘as required’ basis. The home has written protocols on the administration of these medications, as previously required these have been reviewed. However Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 14 information to guide staff as to the signs of the individual being in pain/distress had not been included. Records show that all staff have completed a ‘Care of Medicines’ course. Sense also have a medication policy in place that requires staff to have a regular medication competence assessment completed. However this has only been done for two members of staff and should be completed for the rest of the team. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 The home has a satisfactory complaints procedure. Adult protection procedures impact on the homes ability to show that service users are being protected from abuse and that their welfare is being promoted. EVIDENCE: The homes complaint procedure includes information on the role of the CSCI in investigating complaints and is available in a picture format and CD Rom. Some of the service users due to their complex needs are not able to make a complaint and are reliant on staff, relatives or an advocate to act on their behalf. CSCI had investigated no complaints from service users or any other source in respect of this home in the past twelve months. At the last inspection in August 2005 the complaint log was not available, this was observed to be in the home at this inspection and showed that no complaints had been received. The last inspection identified that the home has a written prevention of abuse policy that is robust. Refresher training in adult protection has been arranged for staff in May. Some shortfalls were identified with regard to Criminal Record Bureau checks for staff, this is further detailed in Standard 34. Service users records included an inventory of their belongings. These were detailed and regularly updated. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 27, 30 Arrangements are generally adequate to ensure that people live in a homely, comfortable, clean and safe environment. EVIDENCE: Featherstone Road is a domestic style house that is in keeping with houses in the locality. The home was clean and free from offensive odours. The home was warm despite it being a cold day. Since the last inspection one service user’s en suite bathroom has been refurbished, making the facilities easier to use and of a good standard of decoration. It was previously required that a washing machine with a sluice cycle is installed, this has now been done. The laundry room décor was observed to require attention. The walls were quite stained. It was identified at the last inspection that the lounge carpet was badly stained and required replacement. Although this has not yet been done a carpet fitter arrived during the inspection with samples of new carpet for this room. The Manager said that he was in the process of gaining several quotes for the work before putting in a capital bid to Sense. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 17 The staff bathroom is adequate for its purpose but the décor is quite worn, it is recommended that it is redecorated making it a more pleasant facility for staff. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35 The staff team offer consistency of care and have a good understanding of service user needs. Arrangements are in progress to ensure staff receive the training they need. Staff records require improvement to evidence that service users are being safeguarded by satisfactory recruitment procedures. EVIDENCE: It was noted that both staff and service users appear comfortable in each other’s company, staff give support with warmth, friendliness and patience and treat people respectfully. It is a strength of this home that many of the staff have worked there for some time, service users are therefore supported by staff who know them well. The training matrix for the home shows that all but one of the staff have completed an NVQ in care, this meets the standard of 50 of staff having an NVQ. The home does not have any staff vacancies. One member of staff has recently been seconded to another Sense home but is due to return at the end of the month. Rota’s show that the current staffing numbers are adequate to meet individual need. A practice development worker and an agency member of staff who does driving duties are also available for two days per week. At the last inspection in August 2005 the previous manager was unable to locate records to show that staff had satisfactory Criminal Record Checks undertaken. Requirements were made to ensure they are available. It was Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 19 therefore disappointing that they were again unavailable. The Manager said he had completed a recent audit of staff files but was unable to locate it. Evidence was sent to the CSCI following the inspection to show that staff had CRB checks. It was identified at the last inspection that staff needed refresher training in many areas. Since then the Manager has completed a full audit of the training needs of the staff team. Recently some staff had received physical intervention training. Staff have also been booked on to challenging behaviour, food hygiene, health and safety, manual handling and epilepsy training, scheduled to be completed by May. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 41, 42 Adequate management arrangements are in place to ensure that service users benefit from a well run home but the home must have a registered manager. Arrangements to ensure the health, safety and welfare of service users needs minor improvement. EVIDENCE: The home has undergone several changes of manager. A new manager is now in post who was previously the deputy manager of the home. He has completed an NVQ 3 in care and is commencing level 4. An application for registration needs to be made to the CSCI. Records were kept up to date and were generally satisfactory. A minority of service users records sampled were not descriptive about service users behaviour. One record sampled said, “ Has been agitated today.” There was no further detail about how the service user was agitated or how they were supported. However there was evidence that the Manager is addressing this. Clear guidelines have recently been introduced for staff regarding good record Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 21 keeping practice. A team building day is also planned for March, the focus being on record keeping. Certificates evidenced that gas appliances had been serviced and electrical installations and equipment were safe. The homes fire records were observed, these indicated that regular testing of the alarms and emergency lighting is generally carried out. Unfortunately the fire alarm test for the week of the inspection had not been done. An immediate requirement was made for this to be carried out. Certificates of servicing were available for the fire alarms. Records evidence that a recent fire drill had been conducted. Records evidence that staff have received fire training in the last six months. Fire doors had been repaired as required at the last inspection. Up to date detailed risk assessments for the premises, risk of fire, staff and food had been completed. Staff test the water temperatures regularly, these show the water is maintained at a safe temperature. Fridge and freezer temperatures are tested to ensure food is stored at the correct temperature, however some gaps were observed on the records. Meat in the freezer was observed not to have been dated on the day of freezing. It is important this is done to reduce the risk of food poisoning. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 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 2 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 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 2 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 X X 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X 2 X 2 X X X 2 2 X Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 23 Are there any outstanding requirements from the last inspection? Yes 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 17(2) 4(1,2) Requirement Additions are required to the Service Users Guide. To include: current manager details and any additional charges to the service user. Outstanding requirement from 7/12/04. Ensure all care plans are reviewed at least six monthly. Topical creams and ointments must be dated on opening and discarded after 28 days. Outstanding requirement from 5/8/05. As required protocols for medication require further development (to guide staff to the signs of individual being in pain). Outstanding requirement from 30/9/05. Lounge carpet- stains must be removed or the carpet replaced. Laundry room: arrange for redecoration. The home must have the required staff records available in the home to include evidence of CRB checks. Outstanding requirement from DS0000016715.V283608.R01.S.doc Timescale for action 31/03/06 2. 3. YA6 YA20 14 13(2) 31/03/06 14/03/06 4. YA20 13(2) 31/03/06 5. YA24 23(2) 30/06/06 6. YA23YA34 19 13(6) 14/03/06 Featherstone Road, 58 Version 5.1 Page 24 30/9/05. 7. YA35 18(1)(c) Ensure all staff have received refresher training to include; - Adult protection - Physical Intervention - Food hygiene Outstanding requirement from 7/12/04. Staff must also have received epilepsy training. An application for registration for a manager needs to be made to the CSCI. Improve measures in place to reduce risk of food poisoning to service users: Ensure fridge and freezer temperatures are monitored on a daily basis and meats labelled with date of freezing. Ensure fire alarms are tested weekly with a record maintained. 30/05/06 8. 9. YA37 YA42 9 13(4) 31/03/06 14/03/06 10. YA42 13(4) 15/02/06 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. 3. Refer to Standard YA20 YA24 YA9 Good Practice Recommendations Medication competence assessments should be completed six monthly for staff in line with Sense policy. The staff bathroom is adequate for its purpose but the décor is quite worn, it is recommended that it is redecorated making it a more pleasant facility for staff. Risk assessments. It would be beneficial if evidence of evaluation of the assessments was recorded on the review sheet in addition to the current system of staff just signing to say they had been reviewed. Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Featherstone Road, 58 DS0000016715.V283608.R01.S.doc Version 5.1 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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