Inspection on 18/10/06 for Harborough Road

This inspection was carried out on 18th October 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Harborough Road 22/08/07

Harborough Road 03/11/05

Harborough Road 28/06/05

Harborough Road 21/10/04

Harborough Road 07/04/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Harborough Road 1a Harborough Road Rushden Northants NN10 0LT Lead Inspector Linda Clarke Unannounced Inspection 18 October 2006 10:00 th Harborough Road DS0000012796.V313762.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 Harborough Road DS0000012796.V313762.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. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Harborough Road Address 1a Harborough Road Rushden Northants NN10 0LT 01933 413163 01933 413163 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) Royal Mencap Society Mrs Sheila Nichol Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd November 2005 Brief Description of the Service: Number 1a Harborough Road is part of the Royal Mencap Society and is a care home providing personal care and accommodation for up to four adults with a learning disability. The care home is situated in the residential area of Rushden. The accommodation is over two floors, with access to the first floor via a stairwell. All bedrooms are single, one of which being located on the ground floor; bathroom and toilet facilities are located on both the ground and first floor. There are limited car parking facilities to the front of the property, and a courtyard garden is located to the rear of the garden. Information as to the facilities and services offered is available to prospective service users upon request; and are available in both written and symbol format. Commission of Social Care Inspection Reports are located in the office. The weekly fee is between £310.00 as detailed within the Pre Inspection Questionnaire, additional costs for individual expenditure such as Chiropody, and hairdressing services are payable, the amount being dependent upon the services received. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection that included a visit to the home and inspection planning. Prior to the home visit, the inspector spent half a day reviewing the last inspection report, and information relating to the home received since that inspection, which includes the Pre Inspection Questionnaire. Four Service User Comment Cards, one General Practitioner Comment Card and three Health Care professional Comment Cards were sent out by the CSCI as part of the inspection process, of which one General Practitioner Comment Card was received. During the course of the inspection, which lasted five hours, the inspector checked all the ‘key’ standards as identified in the National Minimum Standards. This was achieved through a method called case tracking. Case tracking means that the inspector looked at the care provided to two service users; talking with the staff who support their care; checking records relating to their health and welfare; and viewing their personal accommodation as well as the communal living areas. Other issues relating to the running of the home, including health and safety and management issues, were inspected. The inspector spent time with service users, who were unable to express their views, and discussions with the Registered Manager. What the service does well: Relationships between staff and residents appear to be very good a significant reason for this is the length of time in which service users have resided within the Home. Residents are provided with protection through good recruitment practices and staff awareness about their responsibilities in relation to protecting residents. Standards of health care and support are good, as service users benefit from accessing a variety of health care professionals. The home is clean, tidy, well maintained and decorated and comfortably furnished. The General Practitioner who submitted the a Comment Card wrote, “Staff are helpful and friendly, I am happy with the care they provide for the clients.” Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 6 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. Harborough Road DS0000012796.V313762.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 Harborough Road DS0000012796.V313762.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1. Standard 2 is not currently applicable. Quality in this outcome area is good. This judgement has been made using avaialble evidence including a visit to this service. Information for prospective service users is available. EVIDENCE: Information regarding the services and facilities, which Harborough Road provides is incorporated within the Statement of Purpose and Service User Guide these detail the initial assessment and trial period, information as to the aims and objectives of the Home, information on staffing, advice on raising concerns along with environmental information. The Service User guide is produced in both written and symbol format, and are available to service users. The current service users have resided at the home for thirteen years, therefore the Inspection process did not consider as to how the assessment of service users is undertaken. The records of two service users viewed contained a licence/tenancy agreement which outlines the terms and conditions of service users occupancy at Harborough Road. Harborough Road DS0000012796.V313762.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. A good standard of personal care is provided to service users however care planning processes do not identify and fully support personal goals and aspirations. EVIDENCE: Care plans and risk assessments are in place which reflect the care needs of service users residing within the Home, the format and organisation of these and daily records is complex, however these are currently in the process of being re-developed and will incorporate service user goals and expectations. The revision of care planning has been ongoing for a considerable amount of time, in part hindered by the Registered Manager being responsible for the day to day running of two homes. The Registered Manager advised that herself along with a number of Support Workers were in the process of receiving training in Person Centred Planning, which would support staff in the continued development of care plans reflective of service user views, aspirations and goals. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 10 Daily records did not support decisions made by service users, although the service users do not have verbal communication skills, other forms of communication exist between the service users and staff, which has developed over the years. Communication styles will be incorporated into the revised care plan style. The decisions of service users should be recorded, along with decisions made on their behalf, including recreational and leisure interests. Financial agreements are in place, which identifies the organisations responsibility for the management of service user finances, records viewed evidenced that service users have individual Savings Accounts. Harborough Road DS0000012796.V313762.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16 and 17. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user access to community resources is not in all instances reflective of their expectations. EVIDENCE: Three service users attend various day care facilities on a part time basis, which reflect their individual needs, the Registered Manager highlighted as to how two service users whose needs have recently changed have impacted on the lifestyle of all service users, and that one service user no longer attends a day care facility. All service users in theory receive a ‘Quality Day’ each week, the aim of which is to enable the service user to receive individual and personalised care and to access community resources. The reality of this however falls short, due to the changing needs of two service users who either require additional staff support or who no longer attend formal day care, which has resulted in service users being with the Home with greater frequency. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 12 The ability of staff to therefore support service users on their ‘Quality Day’ has been compromised. The Registered Manager advised that staff are working additional hours to support service users, however this is not a formal agreement and not guaranteed. The Registered Manager advised that she has liaised with the Care Manager of Social Services for a review of service users needs to take place, however the Registered Manager said that representatives of Social Services did not attend the review process and therefore additional resources have not been discussed or agreed. The Registered Manager confirmed day trips had taken place, and records reflect that all service users have attended a holiday during the summer of 2006. Records do not in all cases record as to when service users take part in activities or as to when scheduled events do not take place and the reason for this. Meals are prepared by the Support Workers, and menus viewed evidenced choice, meals reflect service user preferences. Harborough Road DS0000012796.V313762.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20. Quality is this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users health and welfare needs are met by a variety of health care professionals. EVIDENCE: Discussions with the Registered Manager and Support Workers evidenced that service users needs with regards to personal support is clearly understood by care staff. One service user requires additional support for bathing, and has specialist equipment in place to facilitate this. Service user records detail access to various healthcare professionals, which include Psychiatrist, Psychologist, and Community Nurses within the field of Learning Disability, Opticians, Dentists and General Practitioners. Medication records of two service users were viewed and were found to be in good order. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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. Quality is this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by staff who are trained in promoting service user rights. EVIDENCE: Harborough Road has a complaints procedure; the Pre Inspection Questionnaire submitted to the Commission for Social Care Inspection, recorded that the Home has not received any complaints in the last twelve months. The Commission for Social Care Inspection has not received any complaints or concerns. The staff training record detailed that staff have undertaken training in the subject of ‘Safeguarding Adults’, which provides staff with underpinning knowledge, enabling staff to promote the health and welfare of service users. Members of staff spoken with were able to state how this knowledge is implemented with regards to all care practices. The Registered Manager advised that accessing advocacy services for service users was very difficult. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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, 26, 27 and 30. Quality is this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a clean, tidy and comfortable home. EVIDENCE: Communal facilities include a dining kitchen and a lounge, which has access to the rear courtyard and garden area, in addition the ground floor provides one bedroom and bathroom facility, to the first floor there are three additional bedrooms a bathroom and separate toilet. The bedrooms of two service users were viewed, and were found to be clean and tidy, the Registered Manager advised that service users contribute to the decision as to how the room is to be decorated. The ground floor bathroom was viewed, and contained specialist equipment for the purpose of assisted bathing. To the rear of the property is a courtyard garden, which provides a seating area and benefits from a gazebo and is surrounded by mature shrubs and plants. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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): 32, 33, 34 and 35. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by trained staff, however current staffing levels are not in all circumstances meeting the needs of service users. EVIDENCE: Harborough Road employs eight members of care staff of which four have attained a National Vocational Qualification (NVQ) level 2 in Care, whilst one staff member has attained both level 2 and level 3, this represents 62.5 of the care staff group. In addition five members of care staff have attained the Learning Disability Award Framework (LDAF) which is a vocational qualification dealing with aspects of caring for individuals with a Learning Disability. Additional training attended by staff includes manual handling, fire, first aid, food hygiene and health and safety. Specific areas of training, which reflect the needs of the service user group, should be considered enabling staff to support service users with greater effect, for example training in Autism. The staff rota and discussions with the Registered Manager confirmed that there are two members of staff on duty throughout the day, with one member of waking night staff supported by a member of staff sleeping in. The staffing levels have not been reviewed since the needs of service user have changed, Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 17 which is impacting on the quality of life service users are able to experience external to the Home. Care staff in addition to care duties are responsible for ancillary tasks, such as cooking, cleaning, washing and ironing. One member of staff has been recruited since the last Inspection; records viewed confirmed that pre-employment checks had been attained, including a Criminal Record Bureau check and two written references. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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, 39 and 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service user live within a well maintained environment, however quality assurance mechanisms and managerial arrangements have impaced on care provision. EVIDENCE: The Registered Manager has attained the Registered Managers Award and has a National Vocational Qualification level 4 in Care. Discussions with the Registered Manager confirmed that until recently she has been overseeing the day to day running of another care home in addition to Harborough Road, and that this has impacted on the efficient running of the service such as the development of care plans and the reviewing of service user needs. Quality Assurance questionnaires developed by the Royal Mencap Society are circulated to the service users residing at Harborough Road, however of the two files viewed only one had been completed by the Key worker on behalf of the service user. The Registered Manager confirmed that Quality Assurance Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 19 questionnaires are not in place for other for relatives or professional support services. One aspect of Quality Assurance is the responsibility of an individual appointed by the Royal Mencap Society to undertake unannounced visits at least monthly to the home. in order to ascertain information as to the day to day running of the Home, a copy of the outcome of the visit should be then submitted to the Commission for Social Care Inspection (CSCI), records indicate that a copy of such visits has not been received since April 2006. The pre-inspection questionnaire submitted by the Registered Manager evidenced that systems within the home are maintained, which includes fire equipment, specialist equipment and the central heating system. Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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 Standard No Score 1 3 2 N/A 3 X 4 X 5 3 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 3 27 3 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 3 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 2 15 2 16 2 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 2 X X 3 X Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 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 YA33 Regulation 18(1) Requirement The Registered Person to ensure that staffing levels are reviewed, and that numbers of staff on duty can effectively meet the needs of service users. The Registered Person to ensure that visits are undertaken unannounced on at least a monthly basis by a representative of the registered provider to ascertain the information required by this requirement, and a copy of their findings to be submitted to the Commission for Social Care Inspection. Timescale for action 31/12/06 2 YA39 26 31/12/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Harborough Road DS0000012796.V313762.R01.S.doc Version 5.2 Page 23 - 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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