Inspection on 03/11/05 for Harborough Road

This inspection was carried out on 3rd November 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 found no outstanding requirements from the previous inspection report, but made 1 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 18/10/06

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 Mrs Kathy Jones Unannounced Inspection 3rd November 2005 13:45 Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 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 (Housing & Support Services) Mrs Sheila Nichol Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 June 2005 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 DS0000012796.V262471.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over two and a half hours on the afternoon of a weekday. Prior to the inspection the Inspector spent one and a half hours reading the last inspection report, the homes service history and pre-inspection information submitted by the registered manager in order to plan the areas to be inspected. The inspection involved talking to staff on duty about recruitment practices, training that they have received and the general care of residents. A sample of residents records were reviewed to check how their care is planned and supported and how previous requirements had been met. Residents at Harborough Road are unable to communicate verbally however interactions and responses to Staff were observed throughout the inspection. Discussions were held with staff about how they ascertain resident’s needs and protect residents. Following the inspection some additional information was checked with the registered manager who had not been present at the time of the inspection. Verbal feedback on the inspection findings was also given. What the service does well: The home is well managed and has a team of staff who present as very caring and committed to ensuring that residents have as full a life as possible. Relationships between staff and residents appear to be very good and care is taken to introduce new staff to residents gradually. Residents are provided with protection through good recruitment practices and staff awareness about their responsibilities in relation to protecting residents. Standards of care and support appear to be very good which is supported by comments from a relative. Specialist support and advice is sought for residents as their needs change. The home is clean, tidy, well maintained and decorated and comfortably furnished. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 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.V262471.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): This section of the standards was not assessed during this inspection. This section of the standards was not assessed during this inspection. EVIDENCE: This section of the standards was not reviewed during this inspection. Standard 2 the key standard to be inspected during a twelve month period has not been reviewed as it relates to the assessment of prospective residents, which is not applicable, as the home has had no new admissions. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 A good standard of care is provided to residents however care planning processes do not identify and fully support personal goals. EVIDENCE: 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 requirement was made at the last inspection for the care plans to include personal goals and demonstrate opportunities for personal development. A sample check of a resident’s file and discussion with staff identified that this requirement has not been met. A requirement for more specific information to be included in a care plan for the management of seizures has been met. A comment card from a relative received prior to the inspection confirms that they are satisfied with the overall care provided. It is difficult to ascertain resident’s views on the care provided, as residents have no verbal communication. However observations indicate good relationships between Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 10 residents and staff and staff have a good understanding of Residents and their individual needs and preferred routines. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 16, 17 Staff are supportive of residents needs in relation to activities and stimulation however residents would benefit from a more planned approach to ensure their needs are met. EVIDENCE: All of the Residents attend day centres and two residents attend evening classes. On the day of the inspection two residents had attended a day centre, one had been shopping for the day to purchase new clothes and one resident who was staying at home had been for a walk in the local area with a member of staff. Residents attend different day centres and the appropriateness of these is kept under review. Staff confirmed that reviews have been arranged in respect of two residents regarding how their needs are being met in day care services. One older resident is finding the day centre quite noisy and another’s needs do not appear to be met in the particular day care service. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 12 At the present time activities occur if and when there happen to be sufficient staff with the necessary experience and skills on duty rather than being planned for and staff being arranged to meet the requirements. Care plans identify individual interests however there is no plan in place to determine how and when the activities will be provided. Routines in the home are based around resident’s needs and attendance at day centres. The inspector observed residents to have their own individual routines on arrival back at the home from day centre, which they were comfortable with and staff were aware of. Staff were observed throughout the inspection to include residents in conversations rather than talking exclusively between themselves or to the inspector. A sample of menus submitted with the pre-inspection information confirms that residents have a varied diet. A beef casserole was being prepared for the evening meal on the day of the inspection. Staff confirmed that most of the meals are prepared using fresh ingredients rather than convenience foods. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 The overall standard of care and personal support is good and health care services are being accessed. EVIDENCE: Discussions with staff confirm that they are aware of the individual support needs of residents. Two staff had been shopping with a resident to purchase new clothes and she appeared pleased with the purchases. Staff confirmed that although the resident has no verbal communication they are careful to ensure that she has indicated her preferences. The resident appeared to have enjoyed the day out which had included lunch and a hair appointment had been booked for later in the day. A sample check of a residents records and discussion with staff confirmed that health care services are accessed on behalf of residents. Specialist support and advice is sought as needs and behaviours change. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Staff are aware of their responsibilities in relation to the protection of residents and of how to raise concerns on their behalf. EVIDENCE: A comment card from a relative stated that they were not aware of the homes complaint procedure although they had not needed to make a complaint. This was discussed with staff and advice given to send a copy out to relatives periodically to remind them of the process. Discussion with staff confirmed that they are aware of their responsibilities in relation to the protection of residents. Staff confirmed that they had no concerns about how any of the residents are treated but were clear that if they had they would have a responsibility to report it and ensure that residents were protected. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 Residents live in a clean, tidy and comfortable home. EVIDENCE: Bedrooms and bathrooms were not inspected during this visit however the kitchen and lounge were very clean and tidy and there were no unpleasant odours in the home. Staff confirmed that infection control procedures are in place, and that protective aprons and gloves are used to reduce the risk of transferring infection. Hand washing liquid and towels are available. Staff advised that paper towels are not currently used due to resident’s behaviours. The inspector would advise that this is considered again with perhaps a different location for the towels. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 33, 34, 35, Residents are supported by a trained, caring and committed staff team however staffing levels need to be carefully monitored to ensure they are based on residents needs. EVIDENCE: Discussion with staff identified that as some staff had left the rota had been reviewed and new posts advertised with hours that will be more suitable in meeting residents needs. Staff felt that this might resolve the problem highlighted in the lifestyle section where residents activities are determined by staffing levels rather than staffing being planned to meet resident’s needs. Comments received from a relative indicate that there is not always enough staff on duty. Staff records are securely stored and were not available as the manager was not in the home at the time of the inspection. The recruitment process was discussed with a relatively new member of staff who confirmed that references including a criminal record bureau check were obtained before she was allowed to work in the home. An interview had taken place, which involved meeting residents. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 17 A member of staff confirmed that she had received a thorough induction and that she had not been expected to work with individual residents until confident to do so. Staff confirmed that they receive training appropriate to meeting resident’s needs, which includes National Vocational Qualification training. Regular staff meetings are held and discussion with staff confirmed that they are very supportive of each other and of the residents. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 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, 42 The home is managed by an experienced and competent manager who promotes and safeguards the health, safety and welfare of the people living in the home. EVIDENCE: The Registered Manager has over the last few months taken responsibility for managing another Mencap home of a similar size in addition to Harborough Road. There is no evidence that this arrangement has had any adverse impact on the home or the care provided to residents. A deputy manager has been appointed to assist with the day to day management of the home. Staff were not sure if there is a formal quality assurance programme in place however confirmed that a representative of the organisation carries out monthly unannounced visits to the home to review the standards of care provided. Discussion with staff indicated that staff meetings are used to discuss improvements that can be made to the care provided. Resident’s views are Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 Page 19 difficult to obtain due to communication difficulties however staff advised that note is taken of residents behaviour in ascertaining if they are happy. The pre-inspection questionnaire submitted by the registered manager confirms that relevant safety checks on the premises and equipment are carried out. Information regarding staff training identifies that staff receive relevant health and safety training including, first aid, food hygiene, fire training and movement and handling. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X X X X Standard No 22 23 Score 2 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score X X X X X X 3 LIFESTYLES Standard No Score 11 X 12 3 13 2 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 2 3 3 X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Harborough Road Score 3 3 X X Standard No 37 38 39 40 41 42 43 Score 3 X X X X 3 X DS0000012796.V262471.R01.S.doc Version 5.0 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 YA6 Regulation 12(1a), 12 (2), 12 3 Requirement Care plans must include personal goals and demonstrate opportunities for personal development. (This is an outstanding requirement with a timescale for compliance of 30.09.05) Arrangements for activities and community access must be incorporated into the care planning process and the necessary support provided. Timescale for action 15/01/05 2. YA 13 16 (2) (m & n) 15/01/05 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. 2. Refer to Standard YA 22 YA 33 Good Practice Recommendations Periodic checks should be made with relatives to ensure that they are aware of the process for making a complaint. The systems used for calculating staff hours needed should be reviewed to ensure that they are based on residents needs as identified in a detailed care plan. Harborough Road DS0000012796.V262471.R01.S.doc Version 5.0 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.V262471.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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