Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 31/03/09 for ICS 60 Ward Grove

Also see our care home review for ICS 60 Ward Grove for more information

This inspection was carried out on 31st March 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

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

There have been no admissions for a number of years, the policies and procedures for admission and pre assessment of needs is good and the manager and staff were able to tell us what they would do to assess and assist soneone to decide if the home was right for them. The assessments and planning of care is good and gives clear information so that staff know how to meet eacj persons needs. Equipment needed to help each person to be mobile is available and staff have received training in moving and handling so that this can be done safely. Staff understand the needs of all the people at this service and communicate well. The environment is clean and homely and each room is personalised as requested by each individual. The staff have recieved a variety of training, this ensures that they have the skills to work with each person and meet their needs appropriately. All staff are checked before they are employed to ensure that they are suitable to work with this group of people.

What has improved since the last inspection?

The manager has assessed the care planning process and this has improved.

What the care home could do better:

Ensuring that there is a record of the amount of all medication of the service needs to be improved. This will ensure that the manager can be sure that medication is given as prescribed by the doctor. Some improvments are needed to ensure that the risk of cross infection is minimised.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: ICS 60 Ward Grove 60 Ward Grove Warwick Warwickshire CV34 6QL     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Paula Dutton     Date: 3 1 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 26 Information about the care home Name of care home: Address: ICS 60 Ward Grove 60 Ward Grove Warwick Warwickshire CV34 6QL 01527546000 01527546888 allan.smith@individual-care.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Isobel Harvie Type of registration: Number of places registered: Individual Care Services care home 3 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: Date of last inspection Brief description of the care home 60 Ward Grove is a registered care home for three younger adults (18 - 65) with a learning disability. The three service users also have physical disabilities and the home has been fully adapted to meet their needs. The home, a bungalow, is situated in a small cul-de-sac in Myton, which is on the outskirts of the town of Warwick. The home has its own transport, which is necessary as local amenities and facilities are not within easy walking distance. All facilities in the home are on the ground floor. The shared space consists of a lounge with dining area, kitchen and bathroom. There are four bedrooms, one is used as the sleep- in/office for staff. The detached garage has been adapted to house the laundry facilities. There is a well-maintained garden at the Care Homes for Adults (18-65 years) Page 4 of 26 Over 65 0 3 Brief description of the care home rear of the property, which is easily accessible to service users. The home is considered to be a home for life for current service users, unless the home can no longer meet service users? needs, or they express a wish to move. Care Homes for Adults (18-65 years) Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 Star. This means people using this service experience good outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living in the home and their views of the service provided. This process considers the care homes capacity to meet the regulatory requirements, minimum standards of practice and focuses on aspects of the service provision that need further development. The visit to the home was undertaken by one inspector and the manager was available to assist in the process. The home did not know that we were visiting on that day. Four people living at the home were available to take part in the inspection. Care Homes for Adults (18-65 years) Page 6 of 26 Information was gathered by speaking to and observing people who lived at the home. All the people living at this service were case tracked which involved discovering their experiences of living at the home by meeting and observing them, looking at their medication records, looking at their personal care plans and reviewing the areas of the home they use. This helps us to case track and to estblish what the outcomes are for these people individually. In addition a range of documents were looked at including staff rotas, staff files, training records and discussion took place with with staff and the manager. Prior to the inspection the manager completed and returned an Annual Quality Assurance Assessment (AQAA). This tells us how the service thinks they are performing and gives us information about their achievements through improvement and their plans for further development. The AQAA and surveys were taken into account as part of this inspection process. Other information that is available to us was also considered. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who are considering moving to the home can access sufficient information to enable them and their advocates to make an informed choice and decision. Evidence: Three people live at the home. They have lived there since 1995. There have been no new admissions since this year. The AQAA told us that should there be a change and a new person was admitted to the home there would be a full and informative assessment and admission process. It told us the home would complete a full assessment and gain all relevant information from other health and social care professionals so that people considering moving to the home can make an informed decision about living at the home. Care Homes for Adults (18-65 years) Page 10 of 26 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home have a care plan designed to meet their needs and to instruct staff of their goals and aspirations. Quality in this outcome group is good. Evidence: Information in the AQAA told us the home offers care plans for each person showing their needs and how staff should assist them so that these are met. It told us the care plan is reviewed so that care plans are accurate and reflect any changes in need. We found that the care plans were detailed and explained peoples care needs with actions to be taken for staff to meet those needs. The home had worked hard in reviewing the information within care plans so that they could be accurate and clear. Care plans had some details about how to promote equality and diversity in assisting people on a daily basis including how to promote sexuality and gender identity Care Homes for Adults (18-65 years) Page 11 of 26 Evidence: through types of clothing and accessories. Care plans held details about how to move people safely and showed the home had gained advice and assessment from health professionals such as Occupational Therapists. The types of equipment needed was recorded and how these should be used. Other issues covered in care plans include communication, key health needs, family relationships, domestic skills and behaviour. Care Homes for Adults (18-65 years) Page 12 of 26 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ward Grove can access meaningful acitivities and can enjoy a varied nutritional menu. Quality in this outcome group is good. Evidence: The AQAA told us the home offers choice of activities both at the home and in the community. It told us activities are meaningful and appropriate. On the day of inspection three people had been out to activities in the community such as day care. When they returned to the home, they were welcomed and offered refreshments. The care plans and daily living notes contained records showing peoples activities Care Homes for Adults (18-65 years) Page 13 of 26 Evidence: over a four week period. The manager explained activities were measured and achieveable. There were long term plans for activities such as holidays. Some people are hoping to go to cottages in Yorkshire for a holiday break. One person was observed to take part in the preparation of the evening meal. The manager explained this was quite a popular choice of activity. The food is ordered over the internet and there is no set menu. The manager and staff team are currently reviewing the menu and considering the variety and nutritional content of the meals chosen by people living at the home. There are nutritional assessments completed by the manager and senior staff to measure eating and drinking to include any risk of choking. Staff have accessed training about dysphasia and how this can affect peoples eating habits. Care Homes for Adults (18-65 years) Page 14 of 26 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home can receive their prescribed medication accurately however the home needs to ensure peoples medication is carefully accounted for through effective stock management. Quality in this outcome group is good. Evidence: The AQAA told us the home has a policy and procedure for the safe administration and management of medications. It said people are able to receive their prescribed medications accurately. The inspection found medication records were accurate and all medications were signed for as given. The manager said staff had received training in how to administer medication. A member of staff said he had recevied training in how to safely administer medication. Medication records for everyone were viewed. The medication records showed all medication had been given and signed for in line with the policy and procedure for Care Homes for Adults (18-65 years) Page 15 of 26 Evidence: administration of medications. Two boxed medications considered high risk were spot checked. Although the record showed all tablets had been given the amount of tablets available did not match the stock record. After discussion it was estblished that excess stock from people being absent over night from the home had been added to the existing stock supply but the record had not been amended to reflect the amount of tablets available on the premises. The manager said this would be addressed. A person living at the home had pressure area care needs due to being physically dependent particularly at night and being unable to turn independently in the bed. The care plan talked about how best to address skin care and to observe for reddening areas due to immobility. Observation of the persons bedroom found the person did have a low level pressure relieving mattress but this was without an impermeable cover. This did not prevent infection control. The manager said she would contact a district nurse to gain up to date equipment. The manager said the home had purchased new equipment for the safe transfer of people including slide sheets which assist in moving people in bed without placing them at risk of skin tears or friction burns. The manager said each person had their own slide sheets so that they are protected from cross infection. This is good practice. Care Homes for Adults (18-65 years) Page 16 of 26 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ward Grove can express their views and influence the operation of the service. Quality in this outcome group is good. Evidence: The AQAA told us the home has a complaints policy and procedure for anyone to express comments or complaints. It said the home encouraged open discussion and viewed complaints as opportunities for improvement. It told us the staff team are knowledgable about how to prevent poor practice when delivering care to vulnerable adults. Observation of staff told us they were respectful when communicating with people living at the home. Staff were careful to position themselves at the most appropriate level and used short sentences with simple language. They gave time to each person who wanted to express an opinion. The complaints procedure is available in the information about the home. The manager explained relatives and advocates are consulted when possible so that the service is running in the best interests of the people living at the home. The training records showed staff had received training in Protection of Vulnerable Care Homes for Adults (18-65 years) Page 17 of 26 Evidence: Adults and the prevention of abuse. A member of staff confirmed they had access to training regularly. The manager said the staff team consider how to protect people at every opportunity. Staff meetings are used to raise these issues regularly whihc is good practice. Care Homes for Adults (18-65 years) Page 18 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Quality in this outcome group is good. Evidence: The AQAA told us the home is well maintained and clean. It said the home has an organised approach to cleaning to ensure standards are maintained at all times. The inspection found the home was very clean. The manager explained how the staff team had organised a schedule of daily routine cleaning and weekly or monthly tasks. A tour of the premises found all areas of the building were very clean. Bedrooms were tidy and clean with evidence of peoples personal possessions being available for them to touch or see. The laundry and cleaning equipment were suitable and stored away from the kitchen and bedrooms. All cleaning products were stored securely. Equipment is available to help each person move around safely. Hoospital type beds are used to enable staff to assist them in bed at different heights. The manager explained that one person had gained approval for the fitting of a ceiling hoist in thier bedroom, and that there is a programme of funding for fitting ceiling hoists for other people living at Ward Grove. Care Homes for Adults (18-65 years) Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ward Grove experience assistance and support from competent and sufficient staff so that their needs can be met. Quality in this outcome group is good. Evidence: The AQAA told us the home responsibly recruits, trains and supervises staff. It said staff have access to training and are supported in their work. Staff were recruited using an application process and appropriate security checks were completed including two written references and a Criminal Records Bureau check. Staff files contained checks outcomes and an induction checklist. All staff are expected to complete a probationary period during which they are able to access training including National Vocational Training in Care (NVQ). The manager explained the home works with Warwickshire College to gain training in care practices. Training for staff in the Mental Capacity Act and how this impacts on the way care should be provided by staff is currently being undertaken. A rota recorded who was on duty and at what time. The rota was for four weeks so Care Homes for Adults (18-65 years) Page 20 of 26 Evidence: that staff knew in advance what shifts they would be working. The manager explained there are at least two people on duty so that anyone who needs moving and handling assistance can have two staff at all times. The manager said the home is keen to promote equality and diversity. The rota reflected gender sensitivity where male and female staff were on duty at the same time. There is only one male member of staff available within the team. Care Homes for Adults (18-65 years) Page 21 of 26 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at Ward Grove benefit from a welll organisedservice operated in their best interests. Quality in this outcome group is good. Evidence: The AQAA told us the home is organised and runs in the best interests of the people living there. It said the home is committed to providing positive outcomes for each person. The manager discussed the operation of the home. A great deal of work has been completed in reviewing the care plans and risk assessments so that documentation meets current guidance. The manager is currenty studying with Warwickshire College in completing the course Leadership in Management. The manager has a long career in providing care in a residential settting. She has worked in a very large residential home in another country for over twenty years Care Homes for Adults (18-65 years) Page 22 of 26 Evidence: working with older people. She is going to apply to be registered as a Responsible Manager with the Care Quality Commission. The manager is present in the home on a daily basis and also completes a weekly sleep in so that she can see people and how they are at different times of the day. The manager observes people living at the home and gathers evidence from staff about how the people are experiencing care services. The manager said the home completes a quality assurance project to establish whether or not the people are receiving positive outcomes. Quality assurance questionnaires are available and do contain pictures to aid choices. Care Homes for Adults (18-65 years) Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 18 13 Appropriate action should be 27/05/2009 taken to minimise the risk of cross infection. This is to ensure that people are protected from infection. 2 20 13 There must be an accurate record of all medication that is held for each person. This is to ensure that accurate audits can be conducted to ensure that medciation is given as prescribed. 27/05/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 25 of 26 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 26 of 26 - 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!