CARE HOME ADULTS 18-65
Ics - Wembrook Close, 8 & 12 8 & 12 Wembrook Close Attleborough Nuneaton Warwickshire CV11 4LJ Lead Inspector
Maggie Arnold Unannounced Inspection 15th March 2006 04:30 Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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 Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ics - Wembrook Close, 8 & 12 Address 8 & 12 Wembrook Close Attleborough Nuneaton Warwickshire CV11 4LJ 02476 327797 01527 546888 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) Individual Care Services Mr Stephen Northcote Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 8 & 12 Wembrook Close operate as a single, linked service, with a shared staff group and manager. May provide accommodation and personal care for up to 5 people in the category of learning disability (3 at number 8 & 2 at number 12). 22nd September 2005 Date of last inspection Brief Description of the Service: 8 and 12 Wembrook Close accommodate up to 3 and 2 residents respectively, in the category learning disability. The houses are situated opposite each other in a small Close. There is one staff group and one manager. Both homes are detached bungalows in a quiet residential area on the outskirts of the town of Nuneaton. The accommodation in each is similar comprising of a shared lounge, kitchen and bathroom. 12 Wembrook Close has two bedrooms on the ground floor. 8 Wembrook Close has two bedrooms on the ground floor and has a further two bedrooms on the first floor, one of which is used as the office/sleep-in staff room. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between the hours of 16:30 and 19:15. At the time of the inspection there was one staff member and two residents in NO 8 Wembrook Close. The third resident was shopping for groceries with the two residents from No 12 Wembrook Close, the home’s manager and a member of staff. The residents and staff returned from the shopping trip at approximately 17:45 On the previous inspection the inspector had spent her time in No 8 Wembrook Close and on this occasion had planned to spend the majority of her time with the residents of No 12 Wembrook Close. However this was not appropriate due toone resident being unwell and both residents were tired and looking forward to their evening meal and a quiet evening. Time with the manager was also extremely limited due to his care commitments towards the residents. For the reasons outlined above some of the outstanding core standards could not be fully assessed. These will be fully assessed at the time of the next inspection. What the service does well: What has improved since the last inspection?
Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 6 Discussions with the manager and Responsible Individual combined with records seen evidenced that three of the four requirements arising from the previous inspection had been met. The fourth requirement had been partly met. The Responsible Individual advised that he was confident that a fire risk assessment regarding a resident’s bedroom door being left ajar at night was appropriate and did not require submitting for the Fire Safety Officer’s approval. Since the last inspection funding has been made available for garden furniture for both homes and the homes now have a weekly gardener. The manager advised that in the last twelve months, a wet room has been fitted in one of the homes to meet the assessed needs of a resident. The manager also advised that both homes have new garden furniture and vertical blinds are being fitted to all of the windows of both homes. 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. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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 Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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 was not assessed this occasion. EVIDENCE: Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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): 7 The residents are encouraged, with support as necessary, to make decisions about their lives. This fosters a sense of self determination and self confidence. EVIDENCE: Within the constraints of group living and subject to risk assessments, the home encourages the residents to participate in making decisions about their lives. For example, residents choose when they wish to go to bed and get up in the morning, choice of meals and activities for the day. Regular resident meetings and individual care reviews also offer opportunities for the residents to be part of the decision making process regarding both individual and group living. The manager advised that the home also works closely with family members who, when necessary will often support their relative in any decision making process. The manager also advised that the home ensures that an independent advocate supports any particularly vulnerable resident. The manager said that the services of an independent advocate and solicitor had been sought to help a resident organise their financial affairs.
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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): 13,16 & 17 Residents are supported to participate in the local community. The home also ensures that residents’ rights and responsibilities are recognised in their dayto-day living. This helps to ensure that the residents’ confidence, well being and sense of identity is promoted and upheld. A varied and nutritional diet promotes the health and enjoyment of the residents. EVIDENCE: Wherever possible the residents’ medical, spiritual, social and personal care needs are met in the local community. For example, residents access the services of local hairdressers, shops, pubs, cafés, dentist and General Practitioners. Some residents also attended church services on either a weekly or monthly basis. Where practical residents also use public transport. The staff member advised that all of the residents receive polling cards but they choose not to vote in local or general elections.
Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 12 As noted in the section headed ‘Individual Needs and Choices’, subject to the restraints of group living and risk assessments, the homes daily routine promotes independence and personal choice. Staff respect the privacy of the residents. Bedroom and bathroom doors are lockable. Residents have a key to their bedroom door. Staff knock on bedroom and bathroom doors. It was noted that a staff member asked a resident for permission to enter her bedroom in order to put laundry away. Where necessary and with the residents permission, staff read correspondence to individual residents. The inspector was advised that correspondence is open in the presence of the resident. With the exception of bedrooms the residents have unrestricted access to their home and grounds. Communal rooms in both houses include a good-sized lounge and separate kitchen. Residents exercise choice as to where they wish to spend their time and to talk to their visitors. For example, at the time of the inspection, one resident was relaxing in the lounge with a hot drink and watching television. The second resident was helping the staff member in the kitchen. Discussions with the staff member and residents evidenced residents have varied and nutritious meals. The staff member advised that all of the residents are encouraged to make healthy food choices. Scrutiny of the menus and a discussion with one of the residents confirmed that residents exercise choice and are not pressurised to all eat the same meals. On the day of the inspection, one resident had chosen lamb chops whilst the other two residents had selected scampi. In order to further improve the nutritional records it is recommended that the home draws up a sample menu and that daily menus contain more detail. For example, although most of the meals, including vegetables, are freshly prepared, this in not reflected in the menus. As on the previous inspection, the kitchen was very clean, orderly and free from excess clutter. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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): This section was not assessed this occasion. EVIDENCE: Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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 The views of the residents are listened to and respected. This helps to promote the residents confidence and helps to reduce the risk of neglect or abuse. EVIDENCE: The home follows Individual Care Services corporate complaints policy and procedures. The document was not seen on this occasion. Neither the Commission nor the home has received any complaints in the last twelve months. The resident spoken to said that they felt confident that their views would be listened to if they were “worried or wanted to complain”. Although not fully familiar with the complaints process the resident was aware that she could talk to her key worker, the manager or other staff. The resident also advised that she would talk to her family members if she wasn’t happy in the home. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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): This section was not assessed this occasion. EVIDENCE: As noted in the summary of this report the inspector spent the majority of her time in No 8 Wembrook Close. One resident showed the inspector her bedroom. The good-sized room was very comfortable and made homely with lots of the residents personal belongings. As on the previous inspection the lounge, kitchen and bathroom were all well presented, homely and clean. The inspector only had a very brief visit to No 12 Wembrook Close. Both of the residents had just returned from shopping and were tired and looking forward to their evening meal. A very quick look at the kitchen and lounge found all to be in good order. There were no potential hazards or unpleasant odours in areas seen in either of the homes. The manager advised that in the last twelve months, a wet room has been fitted in one of the homes to meet the assessed needs of a resident. The manager also advised that both homes have new garden furniture and vertical blinds are being fitted to all of the windows of both homes.
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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): 35 Appropriately trained staff helps to ensure that the individual and collective needs of the residents are met. EVIDENCE: The manager advised that the home has an ongoing training and development plan. Seven members of staff are undertaking National Vocational Qualification (NVQ) Level 2 and one staff member holds a NVQ Level 3. The inspector had the opportunity to have a lengthy discussion with one staff member. The staff member showed the inspector her records of training undertaken. Core training included Food Hygiene, Safe Management of Medication, Emergency First Aid and Health and Safety in the workplace. The staff member advised that she has also undertaken Protection of Vulnerable Adults Awareness (POVA) training. At the time of the inspection the staff were undertaking training in Dementia Awareness. The manager advised that once the training has been completed, staff will undertake a 12 week course in Person Centred Planning. It is intended that the staff will commence the training, which is being provided by North Warwickshire College, in April of this year. The experienced staff member was well informed regarding the needs and preferences of the residents. The staff member was observed to be respectful, friendly and calm when working with the residents.
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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 The home has quality assurance and quality monitoring systems in place that are based on the views of the residents and their advocates. This helps to ensure that the home works towards meeting the needs and preferences of the residents. EVIDENCE: As noted in the summary of this report the inspector had intended to scrutinise standards 37 and 39. However due to the limitation of time, the inspector had just a brief discussion with the manager regarding core standard 39. The manager advised that there are a number of effective quality assurance and quality monitoring systems in place that take into account the views of the residents. For example, regular residents meetings and reviews take place. All of the residents have an allocated key worker who, when necessary, will act as an advocate on their behalf. In addition to being part of the decision-making process regarding redecoration of the home, meals etc. the residents are also Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 19 asked their views of the staff. The manager also advised that the home endeavours to foster good relationships with the residents’ relatives. Regular Regulation 26 visits to the home combined with regular managers meetings also helps to monitor the quality of the service. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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 x 2 x 3 x 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 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 3 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x 3 x x x x Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 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. 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. 1. Refer to Standard YA1717 Good Practice Recommendations In order to further improve the nutritional records it is recommended that the home draws up a sample menu and that daily menus contain more detail. Ics - Wembrook Close, 8 & 12 DS0000004364.V286832.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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