Inspection on 12/07/06 for Hitchin Road (9)

This inspection was carried out on 12th July 2006.

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 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Hitchin Road (9) 10/12/07

Hitchin Road (9) 24/07/07

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 Key Unannounced Inspection 12th July 2006 10:00 Hitchin Road (9) DS0000019431.V304494.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.V304494.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.V304494.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 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) tanners@lifeopportunitiestrust.co.ukwww.lifeopp ortunitiestru Life Opportunities Trust Audrey Alldrick 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.V304494.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th February 2006 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 home charges from £1208 - £1299 per week. 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. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was carried out on 12/07/06 and completed on 18/07/06. The registered manager was not on duty. A senior carer and 3 support staff were present. The home has 7 service users. The inspection began with a tour of the premises. The inspector met with all the service users. Time was spent observing how the staff interacted with them. The majority of the service users have limited verbal communication. Staff were interviewed and documents were examined. Further discussion took placed on 18/07/06 when the registered manager returned from annual leave. (See below for details of the inspection findings). What the service does well: What has improved since the last inspection? In April 2006 the home had a new admission. The service user appeared settled in the home. Since the last inspection, the leakage in the ceiling has been repaired and redecoration has been completed. The grab rails have been fitted and the driveway has been tarmacked. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 6 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. Hitchin Road (9) DS0000019431.V304494.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.V304494.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, 2, 3, 4, 5. Prospective service users have the information they need to make an informed choice. Prior to admission, each prospective service user is assessed to ensure that the home can meet all their needs. Each service user is given a Service User Guide on admission to the home. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The Statement of Purpose and a copy of the last inspection report were available for service users, visitors and others. The home has recently admitted 2 new service users. Their files examined showed evidence of pre-admission assessments that were carried out by the registered manager. A trial period was also arranged. One service user had a review on 12/06/06 and the other was on 20/06/06. The service users’ care needs were identified and they were properly documented. A copy of the contract of agreement was in the personal file. Hitchin Road (9) DS0000019431.V304494.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, 8, 9. Service users are given the opportunity to make everyday choices and they are encouraged to achieve independent lifestyles. Their preferences and requests are respected. Each service user has a care plan. However not every care plan has been updated to reflect the changing needs of the individual. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The service users in the home have limited communication skills. However, members of staff interacted well with them using words and gestures that the service users understand. There was a good rapport between the staff and the service users, who also have access to local independent advocacy and support schemes. The care plans examined indicated that the majority of the service users had their care plan reviewed and updated and their changing needs were reflected in the care plans. Risk assessments were carried out when necessary. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 10 However, one service user’s changing care needs in recent weeks were not documented and therefore the written care plan was not updated. A recent incident highlighted the need for a full review with the involvement of the local Learning Disability Team of Social Services. The registered manager must ensure that the changing needs of a service user are appropriately documented and that each written care plan is regularly reviewed, document, signed and dated. (See Personal and Healthcare Support Section). Hitchin Road (9) DS0000019431.V304494.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): 11, 12, 13, 14, 15, 16, 17. The daily routine promotes independence and individual choice. The activity programme is planned to suit individual needs and interests. Service users are encouraged to maintain contact with their family and friends. A healthy diet is promoted. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: One service user attended the day care centre Monday to Friday. 3 other service users attended twice a week. Members of staff at the day centre assist each day. Transportation is provided by the home. The 2 recent admissions had chosen not to attend the day care centre but prefer to spend time planning their own activities with the support of the staff. One service user was seen relaxing to the sound of music and tea was offered and served at the time he specified. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 12 On the day of the inspection, a member of staff had bought him a portable alarm bell so that he can call for assistance at anytime. Staff respected his request to be left alone but at the same time ensure that he is safe. The community activity co-ordinator visits the home twice a week to assist the service users with indoor activities. Outdoor activities are arranged to suit their individual needs and preferences. One service user spent his birthday in Paradise Park at his request. 2 carers accompanied him. A member of staff prepares the meals daily. The manager ensures that the meals provided are healthy and nutritious. A dietician visited at regular intervals to review the dietary needs of the respective service users. On the day of the inspection, the dietician came with a supply of special nutrient drinks for one service user. Hitchin Road (9) DS0000019431.V304494.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, 20. Service users are treated with respect and, in general, they receive personal care and support in the way they prefer and require. However, the equipment (reclining chair) needed for one service user was not reviewed and professionally reassessed to ensure that it was safe to be used in view of the behavioural change in the service user. There is a lack of supervision of service users in the communal areas. Medicines are administered in accordance with legislation. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The inspector arrived at the home at lunchtime and noticed that 5 service users were in the dining room with no staff supervision for sometime after the main course was served. The dessert was served shortly after the inspector arrived. One service user was observed to have regurgitated foodstuff under the chin. In addition, there was little or no supervision of service users in the lounge and no staff were assigned to supervise them during staff hand-over time at 2pm. (The registered manager was on holiday at the time). Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 14 It was observed that a reclining chair that was withdrawn was back in use. In view of the change in behaviour of the service user, it would be unsafe for her to use the reclining chair without proper assessment by an occupational therapist. The reclining chair was immediately withdrawn once the problem was highlighted. It was noted that 2 carers are providing personal care at regular intervals to one service user who had requested to remain in bed. Staff said that they are able to meet her changing care needs with the support of the general practitioner, the district nurses and the social worker. Since the inspection, the registered manager has implemented changes to the shift rota to ensure that a member of staff is allocated to supervise service users in the lounge and at mealtimes. A trained member of staff administers the medication. Regular checks are made to ensure that the medication records are accurately documented. The local pharmacist gives training and advice whenever necessary. The room temperature is recorded daily. A cooling unit is installed in the office where medicines are kept. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23. The home has a robust complaints policy and procedure. Service users’ wishes are respected. Quality in this outcome area is Good. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Staff said that they have training on issues regarding abuse and the protection of the vulnerable. The manager ensures that all staff are aware of the Adult Protection Procedure of Hertfordshire Social Services. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 16 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, 25, 26, 27, 28, 29, 30 The home is generally clean and comfortable. The facilities provided are adequate. However, there are hazards to safety. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has a planned maintenance programme for this year. On the day of the inspection, the premises appeared clean and tidy. Each bedroom seemed comfortable with personal items that reflected the lifestyle of the occupant. One service user interviewed said that he is “quite happy” with his bedroom, which was well equipped with a large as well as a portable television among other personal items. It was noted that the lounge has limited space. One of the reclining chairs was poorly positioned which became a hazard especially for one service user who was pacing up and down in the narrow lounge. The reclining chair has a note to say that it was broken and it was left in the lounge because there was no storage space in the premises. (Arrangements have since been made for alternative storage). Hitchin Road (9) DS0000019431.V304494.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35. Service users are well supported and cared for by a team of dedicated staff. However, staff must ensure that service users are supervised appropriately to ensure their safety at all times. The staffing level is inadequate for the current group of service users. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Discussion with the registered manager suggested that the number of care staff during evenings and weekends should be increase from 3 to 4 in order to meet the needs of the current group of service users. The vacant position left by the deputy manager (who is currently on long-term leave) has been advertised. (See Healthcare and Support Section). It was noted that some members of staff have not had training on Health and Safety as part of their induction course. Staff interviewed said that they would like to have the training. It is recommended that all staff have further training on Health and Safety given by an approved training organisation. (See Statutory Recommendation). Hitchin Road (9) DS0000019431.V304494.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): 39, 41, 42, 43. The home has an effective quality assurance and monitoring system. There has been some deficiency in the administration of service. Quality in this outcome area is Adequate. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The quality assurance and monitoring system is in place. The result of the survey is soon to be published. A copy of the annual development plan has been received by CSCI. The inspection revealed that the health and safety of the service users have been compromised and that the personal records for the protection of service users were not appropriately maintained. However, the registered manager has co-operated with the Commission and she has rectified the issues raised. (See Statutory Requirements and Recommendations). Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 19 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 3 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 2 25 3 26 3 27 3 28 3 29 2 30 3 STAFFING Standard No Score 31 3 32 3 33 2 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 3 X X X 3 X 2 2 3 Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 20 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. 1. Standard YA6 Regulation 15(2) & 17(1)(a) Sch 3 12(1)(b) & 13(4)(c ) Requirement Timescale for action 19/07/06 2. YA18 YA42 YA29 YA24.10 3. YA33 18(1)(a) The changing care needs of each service user must be appropriately documented and each written care plan must be regularly reviewed, documented, signed and dated. The registered manager must 19/07/06 ensure that unnecessary risks to the safety of service users are identified and so far as possible eliminated. Therefore: (a) Service users must be supervised to ensure their safety. A staff should be allocated to supervise service users whenever they are in the communal areas and at meal times. (b) The reclining chair must be withdrawn from use until it is assessed by an occupational therapist. The registered manager shall, 19/07/06 having regard to the number and needs of the service users, increased the number of care workers from 3 to 4 (daytime). Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 21 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 YA35 Good Practice Recommendations It is recommended that all staff have appropriate training on Health and Safety provided by an approved training organisation. Hitchin Road (9) DS0000019431.V304494.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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 Hitchin Road (9) DS0000019431.V304494.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!