Inspection on 03/04/07 for Grafton House

This inspection was carried out on 3rd April 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Grafton House 01/04/09

Grafton House 19/09/05

Grafton House 01/12/04

Grafton House 07/07/04

Grafton House 22/03/04

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

CARE HOME ADULTS 18-65 Brain Injury Services, 49 The Drive Northampton Northants NN1 4SH Lead Inspector Irene Miller Key Unannounced Inspection 3rd April 2007 09:00 Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Brain Injury Services, 49 The Drive Address Northampton Northants NN1 4SH 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) 01604 719211 01604 791988 hstorr@partnershipsincare.co.uk Partnerships In Care Limited Mrs Helen Elizabeth Storr Care Home 3 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (4) of places Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. All service users accommodated will have an acquired Brain Injury. The age range of the Service Users accommodated are between 30 60 years No one falling within the category MD may be admitted into the home where there are 3 Service Users of this category already accommodated within the home To be able to admit the named person of category MD named in variation application dated 19/02/2005 Number: V000017870 10th February 2006 4. Date of last inspection Brief Description of the Service: 49 The Drive is a care home providing personal care and accommodation for 3 service users from the age of 30 to 65 years with an acquired brain injury. The home is owned by Partnerships in Care Limited. The Registered Manager is Mrs. H. Storr. The Home is situated in a suburb of Northampton close to a local shopping centre and park, easily accessible by public transport and within a mile and a half of the town centre and its amenities. The property consists of a large semi-detached house with front and rear gardens. Single bedrooms are provided for all service users on the first floor. The communal rooms include a lounge; separate dining room, conservatory, and service users have the use of the kitchen. The current fees are £1,932.00 per week and additional charges are made for hairdressing, toiletries, newspapers, magazines and gym membership. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is based upon outcomes for service users and their views of the service provided. This inspection was a ‘Key Inspection’ that focused on the key standards under the National Minimum Standards and the Care Standards Act 2000 and the Care Homes Regulations 2001, for homes providing care for younger adults (18 – 65). The primary method of inspection used was ‘case tracking’ which involved, reviewing the health, social, emotional and physical needs of the three residents living at the home and tracking the care and support that they receive. The residents care plans were looked at (a care plan sets out how the home aims to meet the, personal, health, social and emotional needs of the resident), and discussion took place with residents and staff and general care practices were observed. The homes policies, procedures and records in relation to staffing recruitment and training, concerns and complaints, medication management, and general maintenance and upkeep of the home were viewed. The inspector spent approximately two hours planning the areas to focus on at this inspection, based upon information gained from reviewing the homes previous inspection reports and other information relating to the home. The registered manager Helen Storr was available at the home on the day of inspection; the inspection took place over a period of approximately four hours. What the service does well: There was detailed information available on how residents were to be supported in regaining skills that had been impaired or lost through their brain injury. Risks were well managed, balancing the resident’s rights to make decisions and take risks and there is a commitment to ensuring that residents follow their individual routines, which promote progress in developing skills and independence. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 6 In discussion with staff and through observations of care practice it was demonstrated that the staff ensure that residents healthcare needs are met with sensitivity and that they uphold the residents rights to choice, privacy and dignity. There is an effective system in place for residents and their representatives to raise any concerns or complaints they may have about the service, staff recruitment practices are robust and training is provided on safeguarding adults. Advocacy services are provided for residents. Regular health and safety audits identify where environmental and procedural systems need improvement. Quality assurance systems are in place to gain the views or residents and their representatives, and weekly residents meetings take place. In addition a representative of the organisation carries out monthly-unannounced visits to check standards of care in the home, and health and safety audits take place regularly. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standard 2 Quality in this outcome area is good. Prospective residents and their representatives can be assured that admission will only take place once it has been established that the home can fully meet their assessed needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans viewed had detailed assessments in place, that had involved other healthcare professionals and there was detailed information available about the resident’s lifestyle prior to and following their brain injury. Written contracts of care were held on each resident’s file that set out the terms and conditions of residence in the home, and these were signed by the resident, or they’re representatives and the registered manager. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7 & 9 Quality in this outcome area is excellent. Residents are encouraged and supported to take risks to promote independence. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care plans had comprehensive information available on how residents were to be supported in regaining skills that had been impaired or lost through their brain injury. Detailed information was available on individual daily routines, which outlined the individual support required for each resident. Risk assessments were regularly reviewed and updated as needs change and progress achieved in the residents set goals. The risk assessments identified what control measures were in place to allow residents to take risks and have a good level of independence in line with their level of understanding and capabilities. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 10 In conversation with residents and staff it was confirmed that the residents were aware of their individual rehabilitation programmes and pleased with the support provided, and that staff had an extensive knowledge of the needs of each residents Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11,12,13,14,15,16 & 17 Quality in this outcome area is excellent. The lifestyle experienced in the home meets the needs of the residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Within the care plans there was detailed information on the choices of each resident, and their daily routines were based upon promoting independence and pursuing hobbies and interests. Opportunities to join in with peer and culturally appropriate activities were promoted and there were records available of activities that residents had engaged in such as visits to the local pub, playing pool, out for meals, shopping, going to the cinema and country walks. One resident was taking a Spanish language course and eloquently demonstrated their skills on speaking Spanish, they spoke of their enjoyment Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 12 of working at a garden centre at which they attended three day a week and of making new friends, in addition to learning Spanish the resident had also learned to speak some Czechoslovakian. Staff were observed during the inspection spending time with one of the residents setting up systems for the resident to speak with their relative living overseas through an e-mail video cam link. There was documentation available to support that residents are enabled to building personal relationships and visits to spend time with their families was promoted and facilitated. During weekly meetings the residents decide on the menu for the coming week, the menus seen contained a variety of nutritionally balanced meals, and healthy eating was promoted. Residents spoken with said that they enjoyed the meals. A resident was observed making themselves a sandwich with staff supervision and there was records within the residents daily notes of having helped with food preparation, baking and the setting up and clearing of the dining table and washing up. Observations of care practices during the inspection visit demonstrated that there was a strong commitment to following each resident’s individual daily routines, and in promoting skills and independence. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19 & 20 Quality in this outcome area is good. Residents can be assured that their health and personal care needs will be fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The information contained within the care plans was very detailed, taking full account of the resident’s physical and emotional needs and the advice and support available from healthcare professionals. There were records of residents having received treatment from their general practitioner, and a clinical Psychologist and regular health checks having being provided. Within the care plan of one resident there was detailed exercise instructions for staff to follow to support one of the residents who suffered with a stiffness in their neck, the exercises were intended to easing tension. In discussion with staff and through observations of care practice it was demonstrated that the staff ensure that residents healthcare needs are met Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 14 with sensitivity and that they uphold the residents rights to choice, privacy and dignity. Training in the administration of medication was provided through a DVD training package and staff that holds the responsibility of administering medication undergo coaching and instruction on the homes medication procedures. The medication held within the home was sample checked and was well managed, however there were a small number of staff signatures missing on one of the medication record sheets, this was an area that had been identified for improvement in a recent internal health and safety audit which the registered manager confirmed would be followed up with the staff responsible. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 & 23 Quality in this outcome area is good. Residents and their representatives can be assured that any concerns or complaints they may have will be listened to and acted upon, and that they will be protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There was information displayed on the notice boards in the entrance to the home and within the dining room that contained the procedures to follow should residents or relatives wish to raise any concerns or complaints they may have. Since the last inspection it was noted that no concerns or complaints had been raised at the home or with the Commission for Social Care Inspection. Residents have direct access to an advocate and details of the contact number were on display on the resident’s notice board within the dining room. In discussion with residents they confirmed that they were aware of the process for raising any concerns or complaints, saying that they could talk with any of the staff if they had any problems. Staff training had taken place on safeguarding adults and in discussion with staff it was confirmed that they had a sound knowledge of the importance of protecting residents from potentially abusive situations, this was also demonstrated within the residents individual risk assessments such as the Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 16 support systems in place to ensure residents are safe when out in the community unsupervised. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24 & 30 Quality in this outcome area is good. Residents live in a home that is homely, clean, safe and comfortable. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A limited tour of the building was conducted and residents rooms viewed had been personalised and were furnished and decorated to a good standard. The communal areas were clean, pleasantly furnished and decorated to a good standard, a conservatory to the rear of the dining room was used as a designated smoking area, which led into a well-maintained and pleasant garden. The kitchen was clean and well organised, dry, frozen and perishable foods were stored appropriately and there were records available to demonstrate that food safety systems were in place. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 18 The laundry was clean and well organised and procedures were in place to reduce the risks of cross infection. Records of the building upkeep were viewed and demonstrated that fire; heating, water and gas safety checks were carried out and that there is a programme of building repairs and refurbishment in place. A recent health and safety audit identified that a window was in need of repair on the first floor, quotes had been obtained from contractors and plans were in place to have the window repaired. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34 & 35 Quality in this outcome area is excellent. Residents are protected through thorough staff undergoing thorough recruitment and selection procedures This judgement has been made using available evidence including a visit to this service. EVIDENCE: Records were available to demonstrate that the staff receive all mandatory training such as health and safety, moving and handling, fire awareness, food hygiene and medication training. In addition training is provided in meeting the specific health and emotional needs of residents such as understanding brain injury, behaviour modification, epilepsy and managing challenging behaviour Staff spoken to confirmed that they had received training in the above. There is a very low staff turnover and staff had worked at the home for a considerable length of time, however the recruitment file of a recently employed member of staff was viewed and was seen to contain all of the necessary recruitment and selection documentation. Clearances had been obtained from the Protection of Vulnerable Adults Register (POVA 1st) and Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 20 through the Criminal Records Bureau and references had been obtained prior to the member of staff taking up employment. There were records available of staff receiving 1-1 supervision with their line manager which gave the opportunity for staff to receive individualised support and identify further training needs. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39 & 42 Quality in this outcome area is excellent. Residents live in a home that is run in their best interests and promotes their health, safety and welfare. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has worked at the home for a number of years and has the necessary skill, ability and experience to ensure that the home is managed efficiently. Having obtained a National Vocational Qualification (NVQ) Level 4 and the Registered Manager Award she is currently undertaking a further NVQ level 4 in care. The systems for assessing and reviewing the resident’s ongoing needs and aspirations were well managed, the care records viewed were up to date and Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 22 evidenced that residents were supported through having individualised and detailed care plans in place. Quality assurance systems were in place to gain the views or residents and their representatives, and weekly residents meetings take place. In addition a representative of the organisation carries out monthly-unannounced visits to check standards of care in the home, and health and safety audits take place regularly. Risk assessments were detailed and informed the staff on the control measures in place to reduce identified hazards and ensure residents safety. Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 23 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 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 4 X LIFESTYLES Standard No Score 11 3 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 3 X 4 X 3 X X 4 X Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 24 No Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Derbyshire Area Office Cardinal Square Nottingham Road Derby DE1 3QT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Text phone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Brain Injury Services, 49 The Drive DS0000012717.V335046.R01.S.doc Version 5.2 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. 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