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Inspection on 28/06/05 for Harborough Road

Also see our care home review for Harborough Road for more information

This inspection was carried out on 28th June 2005.

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

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The overall standard of care and support provided is good. Although there have been some recent Staff changes there are a core of Staff who have built up a lot of experience of working with the current Residents at Harborough Road. The Residents at Harborough Road all have quite complex needs and have no verbal communication, they are therefore very reliant on Staff to be fully aware of their individual needs and to have a consistent approach. Residents were observed to be relaxed in the company of Staff and Staff were responding appropriately to none verbal signals from Residents. Staff was also ensuring that Residents were included in conversations. The home is very supportive of Residents in maintaining contacts with families and actively encourages this. The premises are clean, comfortable and appear to meet Residents needs.

What has improved since the last inspection?

Staff has received training in the administration of a particular medication, which may be required for a Resident with epilepsy. Speech therapy has been arranged for a Resident via the day centre and the home are going to be liaising with them regarding any recommendations.A garden swing has been purchased for a Resident, which he was clearly enjoying relaxing on.

What the care home could do better:

The home have plans to introduce person centred planning which may provide a clearer focus on the individual and provide the opportunity to consider how Residents can be supported in expressing more choices and supporting individuals to ensure they are able to achieve their full potential. A more detailed plan for the management of epileptic seizures based on Staff knowledge of the individual and the seizures and professional advice is needed to ensure that Staff is clear as to the point when they should administer medication.

CARE HOME ADULTS 18-65 Harborough Road 1a Harborough Road Rushden Northants NN10 0LT Lead Inspector Kathy Jones Unannounced 28 June 2005 @ 07:45 th 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 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 Stationary 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 C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 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 Only (PC) 4 Category(ies) of Learning Disability (LD) 4 registration, with number of places Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None. Date of last inspection 21/10/2004 Brief Description of the Service: 1a Harborough Road provides twenty-four hour residential care for four adults with a learning disability. The home is run by Mencap and benefits from the support of a wider organisation.The home is situated in a residential street within walking distance of Rushden town centre and local amenities. All residents are accommodated in single bedrooms with one located on the ground floor. There is a comfortably furnished lounge and a large kitchen where residents share their meals with the staff. A small enclosed garden is situated at the rear of the home. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over the morning of a weekday. Residents were in the process of getting up and ready for their daytime activities when the Inspector arrived. As none of the Residents have any verbal communication and communicate their needs to Staff mainly through gesture it was not possible to ascertain their views on the care provided. Judgements regarding the standards of care have been formed from observations of the interactions between Residents and Staff, discussion with a member of Staff about a Residents care needs and a sample check of one Residents care records to see how the care is planned and supported. What the service does well: What has improved since the last inspection? Staff has received training in the administration of a particular medication, which may be required for a Resident with epilepsy. Speech therapy has been arranged for a Resident via the day centre and the home are going to be liaising with them regarding any recommendations. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 6 A garden swing has been purchased for a Resident, which he was clearly enjoying relaxing on. 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 C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 standard(s) This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. The residents at Harborough Road have all lived there for many years and there are no vacancies in the home. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Residents are receiving good support in their everyday lives and have the opportunity to make some choices however care planning processes do not identify and fully support personal goals. EVIDENCE: From discussions with Staff and observations they have developed a good understanding of Residents and their needs. Residents have their own particular routines and given the complex needs of Residents and the fact that they have no verbal communication it is particularly important that Staff is aware of these. Due to Residents having restricted communication abilities it was not possible to ascertain their views on how they are provided with choices. Staff was seen to be providing choices where possible for example several choices of breakfast were offered to a Resident. Staff showed pictures of foods and meals, which are being collated to try to increase choices for Residents. Risk assessments and plans of care are in place to guide Staff as to the actions they need to take to meet each Residents care needs. A sample check confirmed that relevant areas are included however in some cases more specific information is required, for example a care plan for seizures stated Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 10 that medication should be administered if the Resident had an “unusually long seizure”. It is important that more specific guidance is given particularly as there is some fairly new Staff. Although it was apparent that care plans and risk assessments had been added as new risks and care needs are identified care plans were not consistently dated and signed. The Inspector was told that the existing care plans are going to be reviewed and a more person centred approach to care planning is going to be adopted. Currently there is no evidence of planning to meet particular goals in the care plans however this will be part of the new format. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 standard(s) 12 and 15 Residents are involved in daytime occupations and activities and are supported in maintaining links with families. EVIDENCE: All of the Residents attend day centres and their programmes are logged in the Staff handover book. On the day of the inspection three Residents were attending day centre and one Resident was staying at home for the day. Residents appeared to be happy to be going to the various centres. Reviews are held with the day centres and Staff confirmed that they try to liaise with them to ensure consistency of approach. Conversations with Staff confirmed that Residents are supported and encouraged to maintain links with families. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 12 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 standard(s) 18, 19 and 20 The overall standard of care and personal support is good and health care services are being accessed. EVIDENCE: On arrival at the home Staff were assisting Residents with bathing and dressing. Staff was mindful of Residents privacy and dignity and all personal care was provided in the privacy of bedrooms and bathrooms. Residents were all assisted to be appropriately dressed and well presented prior to going to the day centres. There is appropriate equipment to assist with bathing and changing a Resident who has a physical disability in addition to a Learning disability, which has been installed following an occupational health assessment. Staff were observed administering medication to Residents. Medication is checked by two Staff, administered and signed as given to reduce the risk of errors. Staff confirmed that they have received training in the administration of a rectal medication which although hasn’t been required for many years is prescribed for a Resident. It was confirmed that particular Staff have been authorised by a Health Professional to administer this medication. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 13 A member of Staff confirmed that Residents visit the dentist regularly, have visits from the optician and that they are trying to arrange a visit from a dental hygienist. The Registered Manager is also going to contact the Community Nurse to arrange for a full health check to be carried out and health action plan developed. It is recommended that this be pursued to ensure that all relevant health care advice and support is being accessed. Follow up checks and records following accidents were discussed and following the inspection the Registered Manager has advised that more detailed checks and records following accidents or identification of bruising have been introduced. These more detailed records have had the benefit of identifying that the way a Resident has been using the garden swing has been the cause of some bruising. Cushions have now been purchased eliminating the problem. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 standard(s) This section of the Standards was not reviewed during this inspection. This section of the Standards was not reviewed during this inspection. EVIDENCE: This section of the Standards was not reviewed during this inspection. The Commission for Social care Inspection have received no complaints about the home since the last inspection. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 standard(s) 24 and 28 Residents are provided with a clean, homely and comfortable place to live. EVIDENCE: The home is situated in a residential area on the outskirts of the town of Rushden. The home is not identifiable as a Residential Care home. The premises are clean, bright, homely and comfortable in style. The furnishings, fittings and equipment appear to be of good quality. Shared space in the home consists of a dining/kitchen, a lounge and an enclosed garden. Residents were having breakfast in the kitchen during the inspection. Breakfast is served individually as and when Residents are washed and dressed however on previous visits in the evening the Inspector has seen Staff and Residents eating an evening meal together in the kitchen. The lounge is furnished with comfortable chairs and a settee and there is a television. The enclosed garden was well maintained a task, which is carried out by Staff in the home. A Resident was enjoying a recently purchased garden swing. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) This section of the standards was not reviewed during this inspection. This section of the standards was not reviewed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection however no health and safety hazards were identified during the inspection. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 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 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x x Standard No 11 12 13 14 15 16 17 x 3 x x 3 x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harborough Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 19 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 6 Regulation 12 (1) (a), 12 (2), 12 (3) 12 (1) (a), 13 (4) (c ) Requirement Care plans must include personal goals and demonstrate opportunities for personal development. Care plans for the administration of rectal diazepam should be specific about when to administer. Timescale for action 30.09.05 2. 6 30.07.05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 19 Good Practice Recommendations Full health care checks and health action plans for Residents should be sought. Harborough Road C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 20 Commission for Social Care Inspection Northamptonshire Area Office Newland House, First Floor Campbell Square Northants, 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 C51 C08 S12796 Harborough Road V231111 280605 Stage 4.doc Version 1.30 Page 21 - 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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