Inspection on 10/12/07 for Hitchin Road (9)

This inspection was carried out on 10th December 2007.

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.

Other inspections for this house

Hitchin Road (9) 24/07/07

Hitchin Road (9) 12/07/06

Hitchin Road (9) 08/02/06

Hitchin Road (9) 28/10/05

Hitchin Road (9) 08/03/05

Hitchin Road (9) 12/10/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Hitchin Road (9) 9 Hitchin Road Stevenage Hertfordshire SG1 3BJ Lead Inspector Yoke-Lan Jackson Unannounced Inspection 10th December 2007 10:30 Hitchin Road (9) DS0000019431.V356410.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 Hitchin Road (9) DS0000019431.V356410.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. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Hitchin Road (9) Address 9 Hitchin Road Stevenage Hertfordshire SG1 3BJ 01438 352 395 01438 742 865 hitchin@lot-uk.org.uk lifeopportunitiestrust.co.uk www.lifeopportunitiestr Life Opportunities Trust 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) Care Home 7 Category(ies) of Learning disability over 65 years of age (7), registration, with number Physical disability over 65 years of age (7) of places Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registration category will revert back exclusively to `Old Age` for service users over 65 with learning and physical disabilities once the two named service users with dementia permanently leave the home for any reason. 4th September 2007 Date of last inspection Brief Description of the Service: No.9 Hitchin Road is a residential care home provided by Life Opportunities Trust, a charitable organisation. The home is registered for 7 elderly people with learning and/or physical disabilities. It is situated in Stevenage on a busy trunk road leading to the A1(M) and Hitchin. There are parking spaces in the front of the building. Transportation is provided for service users by means of a specially adapted minibus. The Edwardian building was renovated to provide seven single bedrooms, 2 on the ground floor and 5 on the first floor. There is a passenger lift to the upper floor. The two assisted bathrooms and toilet facilities are nearby. The communal space includes a family style lounge that overlooks the back garden and a large dining room with interconnecting hatch to a well-equipped kitchen. A tracking hoist is fitted to the main lounge, the bedrooms, bathrooms and toilets. The administrative office and the laundry room are all on the ground floor. To the rear of the building is a large and attractive garden with mature trees and plants. There are comfortable garden furniture and seating for service users. The garden is accessible to wheelchair users. The home charges from £1208 - £1299 per week. Information about the home and the service it offers is contained in the Statement of Purpose and Service User Guide. A copy of these and the most recent CSCI inspection report are available on request in the home. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out on 10/12/07 and the home manager was present for the visit. The home currently has five residents and 2 vacancies. The inspection included a tour of the premises. Time was spent observing how the staff interacted with the residents. Staff and residents were spoken with and documents were examined. The inspection included a visit by an expert by experience. The expert together with a representative from the Centre for Independent Living spent two hours with the residents. An expert by experience is a person who, because of their shared experience of learning disability and ways of communicating, contributes to providing a better picture of what it is like to live in or use a service such as Hitchin Road. The arrangement for using an expert by experience was arranged by us (the Commission). The information and feedback received from an expert by experience are incorporated into the inspection report. Information received by us since the last inspection was reviewed. This included the random Pharmacy Inspection and the Annual Quality Assessment (AQAA) which providers of registered services are required to complete. The AQAA focuses on how well outcomes are being met for people using the service. What the service does well: The residents have limited communication skills but members of staff interacted well with them using the individual’s preferred mode of communication. The expert by experience found that the members of staff were very friendly and they were readily available to assist the residents who seemed happy. He reported that all but one resident were not able to communicate verbally but staff understood the residents’ facial expressions when they are tired and a member of staff will help them to bed. He observed a resident ‘lying in bed watching their electric fish tank and laughing’. He reported that residents are able to go out when they wanted to, accompanied by a member of staff. One resident is able to go out alone. He further noted that none of the residents smoke but they are allowed to if they wish to do so. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 6 The expert reported that residents have choices in this home. The residents are able to choose their own clothes and they decide for themselves when to wake up and when to go to bed. One resident usually goes to bed at 8:30 pm and this was of choice. One resident likes to listen to music while having breakfast. All the residents have music in their rooms but not all of them have a television out of choice. There were lots of games for residents to choose from. The expert observed that the home was very clean and that there was background music in the dining room. He noted that there are telephones in the entrance hall for residents to use if they so wish and photos of staff were on display in the entrance hall for residents and others to identify them. 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. Hitchin Road (9) DS0000019431.V356410.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 Hitchin Road (9) DS0000019431.V356410.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): Standards 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be assured that they will have the opportunity to visit and assess the facilities and suitability of the home and a pre-admission assessment will be completed before they are admitted to ensure that the home can meet all their care needs. EVIDENCE: The care plans examined confirmed that a full pre-admission assessment is carried out and the home will only admit a prospective resident whose care needs can be fully met. The Manager will carry out the pre-admission assessments. Currently there are two vacancies. Hitchin Road (9) DS0000019431.V356410.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 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they are enabled the opportunity to make everyday choices; their preferences and requests are respected enabling them to achieve independent lifestyles. Each resident can expect to have a written care plan so that staff are able to identify their goals and care needs appropriately. EVIDENCE: The residents appeared well cared for. Members of staff were observed to interact well with them using words and gestures that the residents understand. There was a good rapport between the staff and the residents, who have access to local independent advocacy and support schemes. The care plans examined were detailed and person-centred. Residents’ changing needs were reflected in their written care plans and risk assessments were carried out when necessary. The residents’ care needs are reviewed regularly and documented in their care plan. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 10 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 12, 13, 14, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect that their rights will be respected and that they will be encouraged to lead an independent lifestyle, to engage in communal activities and to be supported to maintain contact with their family and friends. EVIDENCE: Residents are given choices and the daily routine promotes independence. Staff respect their wishes and decisions and assist them accordingly. Most of the residents are not able to communicate verbally but staff understand their body language and gestures and assist them accordingly. The community activity co-ordinator visits the home regularly to assist the residents with indoor activities. Outdoor activities are arranged to suit their individual needs and preferences. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 11 The activity programme is planned to suit individual needs and interests. Some residents attend the local day centre. Members of staff at the day centre assist each day. Transportation is provided by the home. On the day of the inspection, one of the residents was at the day centre. The expert reported that one resident was encouraged to help with the washing up in the kitchen or help in the garden. However, most of the residents are not able to. However, all the residents have access to the garden whenever they want. In the summer months they all enjoy a barbeque party organised by the staff. Some residents enjoy swimming and walking. A resident attends the local church regularly. The residents have their own money and they are able to spend on whatever they wish. A member of staff will accompany them to the bank when they want to withdraw some money from their own bank account. Family members are encouraged to contact the residents in the home. A resident visits family members at weekends. However, the majority of the residents have no family and they consider the staff their ‘family’. Staff handle confidential information in accordance with the home’s policy and procedures and the Data Protection Act 1998. A member of staff prepares the meals daily. The manager ensures that the meals provided are healthy and nutritious. All groceries are purchased online and they are delivered to the home weekly. It was noted that all the residents enjoyed the hot lunch, prepared by a member of staff. Two residents were assisted in an unhurried manner during mealtime. The expert reported that the residents have a choice of fruit and there was a bowl of fruit in the kitchen and that the kitchen fridge was stocked with plenty of food. He noted the different colour chopping boards in the kitchen. The expert reported that a member of staff had said that the residents were not able to make telephone calls. However, during feedback the Manager confirmed that all the residents have access to the office telephone and they are able to make calls if they wish to. A resident had received a call from their brother on the office telephone. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect to be treated with dignity and receive personal care and support in the way they prefer and require and that they will be protected by the home’s medication policies and procedures. EVIDENCE: The residents appeared comfortable and well cared for. They were treated with respect and they received personal care and support in the way they prefer and require. The members of staff were observed to be patient and gentle with them. Staff have a good knowledge of the residents’ conditions, and their likes and dislikes, and deliver care and support accordingly. The home has the support of health care professionals such as the General Practitioner and the Community Psychiatric Team. Health and behavioural concerns are referred to them for immediate assessment. Currently the community nurse is assisting in the home to assess the condition of a resident to ensure that all their care needs can be met in the home. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 13 Since the last inspection the medication policies and procedures have been revised and adhered to. There were no medication errors since the last inspection. The Medication Administration Record charts were correctly filled in. There are no controlled drugs in use at the present time. All staff have had their medication training and a member of staff is waiting to complete her medication supervision training and assessment to ensure competence before she administer medicines. Hitchin Road (9) DS0000019431.V356410.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that they will be listened to and their legal rights will be protected. EVIDENCE: The home has a robust complaints policy and procedure and the residents and relatives have access to them. Residents’ meetings are held regularly and issues raised are taken seriously and appropriate changes are made to improve the care and service accordingly. Staff have training on issues regarding abuse and the protection of the vulnerable. The manager ensures that all staff are aware of the home’s policy and procedure on safeguarding issues and the whistle-blowing policy. The home follows the multi-agency Safeguarding Procedure of Hertfordshire County Council. Since the last inspection there have been no safeguarding issues or complaints raised. Hitchin Road (9) DS0000019431.V356410.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24, 25, 26, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can expect to live in a homely and comfortable environment, with access to all the communal facilities and the specialist equipment they require to maximise their independence. EVIDENCE: The premises are well maintained and have a homely and comfortable atmosphere. There is a rolling maintenance programme. On the day of the inspection, the lounge was neat and tidy. The bedrooms were clean and tidy. There were personal items on display and pictures and posters on the walls. The hoists and wheelchairs have been serviced. All recliners have been risk assessed. The expert reported that there was an overhead hoist in the lounge and he observed that all doors were held open with automatic hold open door device throughout the home. He reported that the garden was very clean and tidy and it was wheelchair-accessible. The home has a gardener who comes regularly to Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 16 attend to the plants and the garden. There were Christmas decorations in the home and a lit Christmas tree in the lounge. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 17 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 31, 32, 33, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service can be assured that the home has an effective staff team who will support them. They can be confident that they will be safeguarded by the home’s robust recruitment policy and procedures. EVIDENCE: Staff have defined roles and responsibilities. They are appropriately trained to ensure that they can meet the service users’ individual and joint needs. Over the years the staff have gained experience in caring for their residents some of whom had dementia. Proper staff records are kept and these are available for inspection. They have had specific training on Medication since the last inspection. Other courses attended included Dementia Care and Epilepsy. All staff have had mandatory training such as Moving and Handling, Fire Safety and Food and Hygiene. The management encourages staff to undertake professional development in addition to mandatory training. The home is currently recruiting senior carers and support workers. Agency workers are employed to make up the staff numbers. The home employs the same agency workers to ensure that there is continuity of care. Hitchin Road (9) DS0000019431.V356410.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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 39, 40, 41 and 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standards of administration and management of the service are well maintained and this benefits the residents as the home is run in their best interests. EVIDENCE: The services are well maintained. Earlier this month the registered manager resigned for personal reasons. The deputy manager has been appointed as the home manager and she is well supported by the provider through the Area Support Manager. Residents are supported to complete a yearly questionnaire as part of a yearly quality assurance and monitoring system. The annual report is readily available for inspection. All servicing records are updated. Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 19 Records about the residents and staff are kept securely. The Liability Insurance certificate and the CSCI Registration certificate are on display in the entrance hall. The home’s Medication policies and procedures have been revised. The management has complied with all the requirements from the last inspection. The yearly CSCI Annual Quality Assurance Self-Assessment (AQAA) form was completed and sent to CSCI on time for this inspection. Hitchin Road (9) DS0000019431.V356410.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 3 3 3 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 3 26 3 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 3 3 3 x Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No 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 . Hitchin Road (9) DS0000019431.V356410.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Inspection Team Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 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 Hitchin Road (9) DS0000019431.V356410.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!