Inspection on 25/07/05 for Iona

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Iona 26/02/10

Iona 11/08/09

Iona 14/09/07

Iona 07/06/06

Iona 25/01/06

Iona 02/03/05

Iona 03/08/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Iona 104 Well Street Biddulph Stoke on Trent Staffordshire ST8 6EZ Lead Inspector Peter Dawson Unannounced 25 July 2005 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 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 Stationary 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. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Iona Address 104 Well Street Biddulph Stoke on Trent Staffordshire ST8 6EZ 01782 523396 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr Alan James Stockdale Mrs Wendy Scully Care Home 6 Category(ies) of 6 LD registration, with number 1 MD of places Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 02 March 2005 Brief Description of the Service: Iona is a care home for younger adults providing personal care and accmmodation for six people with a learning disability. One place can be used to provide a service for someone with mental health needs (Mental disorder). The home is situated close to local amenities very close to Biddulph town centre. There are good public transport links to the home. The building is an older type detached house with adequate secluded garden area with lawn and patio. There is one single ground floor bed room with shower cubicle, further 3 bedrooms on the first floor - 2 double and one single room with has en-suite facility. There is a bathroom on the first floor. The communal rooms provide adequate lounge and dining space. The main lounge is of good size and comfortably furnished, the dining area is little used since the kitchen was refitted which is the preferred dining area for residents. The former dining area is little used being used for activities or visitor use. The home is runon ordinary life principles where residents are supported as needed but are encouraged to maximise their potential with assistance from a professional and caring staff team. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. At the time of this inspection there were 6 people in residence and there were no vacancies. The home provides a comfortable environment and relaxed atmosphere along domestic lines. There was one person on duty for the first 2 hours of the inspection and this allowed considerable time to sit and speak to residents in a relaxed informal way. Residents were quite spontaneous and open about life at Iona and discussions revealed good relationships with staff, who were described in affectionate terms. Chosen lifestyles were evident and residents spoke with interest and enthusiasm about life at Iona and also their contacts in the community. There is a strong family atmosphere with residents showing consideration and concern for each other. No one had any complaints about the running of the home or their live experiences there. All indicated a high level of support and commitment from staff. There is only generally one person on duty throughout the day with some additional hours to support peak times of resident activity. The staffing level is the adequate minimum required for the resident group. The Manager arrived 2 hours into the inspection (although not on duty until afternoon) and stayed to continue the inspection allowing the member of staff to continue with total care of the residents. Redecoration of the bedroom areas is improving the presentation of those rooms. The facilities in the home are adequate and the garden/patio area is attractive, comfortable and private. This has been much used in the recent hot weather spell. Flexibility of routines was indicated with resident rising at around 11 a.m. One resident had gone to day services prior to arrival of the inspector (8.30 a.m.), others had had breakfast, were sitting watching TV in pyjamas or having baths etc. The indications were of a relaxed and satisfied resident group with good standards of care provided. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 6 What the service does well: 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. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) Standards relating to Choice of Home were not made on this visit. This is a static resident group and there have been no admissions to the home for the past 2-3 years. EVIDENCE: Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) 6 - 10 There was evidence that needs were reviewed and reassessments made where necessary. Risk taking was responsibly assessed to facilitate chosen lifestyles and promote independence. EVIDENCE: Care plans were sampled and gave basic information concerning individual needs, they are reviewed on a regular basis. There was evidence of a resident being reviewed and additional funding available to attend specific daytime group. The changing needs of another resident were reviewed on a 3 monthly basis. The needs of a resident are currently being reviewed following a change in physical and psychological needs, this review was initiated prior to the last inspection and continues. Advice was given to the Manager relating to concluding the review. The person has been subject to reviews and changes in medication and there has been input from GP, Consultant Psychiatrist, CPN and other professionals. The recently changed physical needs of a resident following hospitalisation were not changed on the care plan but a meeting arranged with members of the primary health care team on the day of inspection. Changes to the care plan will be put into place following the meeting. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 10 It was reported that residents are involved in reviews of care plans and also changes to plans. Risk assessments were in place relating to resident activity. There was evidence that responsible risks were taken and residents given advice about personal safety to ensure their protection outside the home. Examples were resident pursuing horse-riding interest, people going out unescorted etc. Records are secure in the office area of the home and residents aware of their right to access records. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) 11 - 17 Evidence indicated that chosen lifestyles were met with opportunities provided for social, recreational, educational and person relationships. A range of activities are provided to meet those needs. Standards relating to lifestyle were found to be met. EVIDENCE: A range of activities and social situations are accessed outside the home. Two people go to college regularly, two access day services at Kidsgrove Day Service centre. Two older residents with reluctance to participate in regular day activities outside the home are provided with a range of activities in the home to provide the necessary stimulation. A resident “works” at the local Red Cross shop nearby in Biddulph town several times each week and enjoys the work and the opportunities to meet other volunteers and members of the public and made new friends. She has made very significant progress in social and communication skills and increased her confidence considerably. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 12 There are weekly activity sheets for all residents outlining their programme of social, educational and recreational activity. The resident group are extremely cohesive and it was interesting to note the care and consideration residents gave to each other in discussions and in observations during the inspection. Annual holidays are provided for all residents, usually 2 times each year for approximately 5 days. This is their choice, attempt to offer smaller group holidays are declined the group prefer to go on holiday as a family group and this clearly works very well. They have been to various holiday locations, Wales, Skegness, Blackpool. The group related with enthusiasm a holiday in May at Blackpool where they stayed at hotel and visited Waxworks, theatre, nightclubs etc. Additionally the home have a 6 seater people carrier used for outings, usually with staff car back-up to transport all residents. They go to the theatre 4 times per year, have recently visited Cadbury World and Black Country Museum. Transport is readily available for trips to local areas of interest. All residents have family contacts and visitors, and encouraged to go out with their visitors wherever possible. Residents spoke about their extensive family contacts and clearly visitors are received well into the home. Residents were asked about food provision and all indicated they were satisfied with the type and quantity of food provided at Iona. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) 18 - 20 There is evidence of personal support being given sensitively and health care needs being met. The changed needs of a resident are being reviewed. Medication records suggested a safe system of medication in the home but accredited training is required for all staff administering medication in the home. EVIDENCE: Personal support is given appropriately. The majority of resident require only oversight for personal needs, others need more specific involvement to ensure good personal hygiene standards and one resident specific involvement relating to health care needs. Support was seen to be given discreetly and in private. All residents have daily bath from choice. During the inspection 3 residents were overseen with bathing from the person on duty, one needs assistance with shaving. Residents clearly enjoyed and felt the positive results of bathing given in a relaxed way in private with minimal interventions. They commented on the positive outcome and showed pride in their clothing and general appearance. A resident has recently been in hospital for one week, was visited by his relative and a member of staff, other residents sent a card to him. He has Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 14 since been visited by the District Nurse and advice given to staff concerning his treatment. Staff are keen to follow instructions and will readily refer to the nursing service is there are concerns. This person is presently undergoing a re-assessment of his needs including behavioural and psychological needs. Consultant and primary health care personnel are involved with medication reviews and the home keen to be able to meet his changing needs. The outcome of the review must be recorded and care plan changed as required. Residents access health care needs in the community wherever possible. The Health Centre and pharmacy are directly opposite the home and well man/woman clinics reported to be used by all residents. Medication is provided in MDS (blister packs) from the local Coop Pharmacy and good service reported. None of the present resident group self-medicate. Records were inspected and found to be satisfactory. There is a written policy relating to medication in the home and there are regular reviews (usually 3 monthly) of medication by the GP. There are some new staff in the home and training carried out by the Manager but accredited training in medication administration is required for all staff administering medication and this must be provided. The Manager will make the necessary arrangements. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) EVIDENCE: Complaints and protection were not inspected on this visit. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 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 standard(s) 24 -30 All areas of the home were seen and the premises were comfortable, safe and suitable for their purpose. Redecoration has improved the presentation of bedrooms. Standards of hygiene are good. EVIDENCE: The home is clean and comfortable, furniture and fittings are to domestic standards resembling a home environment. The lounge is very comfortable, bright and has T V; there are adequate comfortable seats sufficient for the 6 residents. The kitchen was upgraded and now also used as the preferred dining area, leaving the former dining area a little surplus to requirements, although it is used for some activities or for visitors/meetings. The kitchen was fitted with domestic fittings and provides good facilities for cooking and serving meals. The home has a handyperson who attend to all minor requirements as they are noted and recorded. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 17 There are 2 single and 2 shared bedrooms in the home. It was a requirement of the last report that one of the shared bedrooms must be repainted and new carpet fitted. Whilst the agreed timescale of 24.4.05 was not met, the room was recently redecorated and it is reported that a new carpet has been ordered and to be fitted in the next few days. The decorators were in the home during the inspection and have redecorated the other shared bedroom and were in the process of redecorating the single bedroom on the first floor. This work will improve the general appearance of bedrooms. The premises are adequate in size for the resident group and the garden area provides a lawn and patio area screened by trees. The premises are not identifiable as a home in the local community. Residents are encouraged to participate in routine domestic tasks which includes cleaning and keeping bedrooms in reasonable order. This is part of social skills development. A resident requires particular encouragement in this area, the room reflected the reluctance but staff were dealing quite appropriately and adequately in providing support to achieve a level of required motivation. Standards of cleanliness throughout the home were satisfactory. Because most bedrooms had been or were being redecorated at the time of the inspection the provision in rooms to meet individual needs will be assessed on the next inspection. Two of the 4 bedrooms have en-suite facilities and there is a bathroom with toilet on the first floor and toilet area on the ground floor, sufficient for the needs of the group. Infection control practices seemed good. A supply of gloves etc. available in the home as required. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 18 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31, 34 and 36 Three standards relating to staffing were inspected. A CRB check had not been obtained for a person commencing duties and this is always required. EVIDENCE: Staff have job descriptions and clearly defined roles. This is a small home providing care for 6 residents with a mild learning disability. Waking night staff are not required but a member of staff sleeps in at all times and is on call. The remaining day staff hours are 98 per week to provide one person on duty at all times. The home provides a weekly number of staff hours amounting to 126 per week, this includes 40 hours worked by the Manager who considers half those hours are required for management duties, although, of course she has a presence in the home for a total of 40 hours per week. This means that the total number of weekly staffing hours (excluding management hours) are 106. Slightly more than one person being on duty alone. It was a requirement of the last report that a review of staffing hours was carried out. The proprietor feels the number of hours is adequate. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 19 The dependency levels of residents is generally low. The number of staffing hours at this time is required to be the level of staffing at April 2002 which was according to the Manager 98 hours per week. The Staffing Formula guide of the Department of Health indicates a total of 139 hours per week which includes hours for social, recreational and cultural activities, but does not take account of any reduction of hours which residents spend outside the home (day centres) or have reduced supervision in the home. If these factors are taken into account the current staffing hours are the minimum required to sustain care for this low dependency resident group. One residents needs are currently being re-assessed, the outcome of this or any additional dependency levels of residents would mean that the number of staffing hours would have to be increased. It is the view of the inspector that the home provides an adequate standard of care for the resident group at this time. There is currently one staff vacancy for 18 hours per week and applicants being interviewed later on the day of the inspection. A new member of staff was appointed and commenced her induction when she decided that the job was not suitable for her. A CRB check had not been applied for in relation to her. The home must always obtain satisfactory CRB checks prior to commencing employment and this is a requirement of this report. It was a requirement of the previous report that POVA checks are carried out in relation to all new staff and this procedure is now in place. Induction is to TOPPS standards and 2 staff are still involved in induction training to that standard. NVQ training will follow induction training. One member of staff has completed NVQ2 training. Only one new member of staff was seen (apart from the Manager) during the inspection the skills and competencies of staff was therefore not possible to assess on this visit. Other statutory training and supervision of staff was not inspected on this visit. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 20 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38 & 42. The Manager has the required experience and skill to run the home and completing the required Registered Managers Award. There appeared good leadership and an open and positive atmosphere. Sampling of some health and safety matters indicated risks were appropriately assessed and reviewed. Time limited inspection of detailed records. EVIDENCE: The Registered Manager Mrs Wendy Scully has the required experience to run the home. She is required to obtain NVQ4 in Management and Care by 2005 and enrolled on the course leading to the Registered Managers Award in January 2005. She hopes to complete the course by the end of 2005 or January 2006 when the standard would be met. There is a very relaxed and homely atmosphere in the home and through observations and discussions with staff there appeared to be an open, positive and inclusive atmosphere. All residents were spoken to privately during the inspection and spoke highly about their involvement with staff and gave many Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 21 examples of good staff commitment. It was clear that their views were sought and respected. Residents spoke in affectionate terms about staff and all were happy with the care they received and the attitude of staff. Some aspects of safe working practices were sampled. All records relating to Fire Prevention were in place, with testing of equipments and drills having been carried out at required intervals. There was a fire risk assessment in place. Risk assessments were sampled relating to resident activity, were in place and reviewed regularly. Policies and procedures were not inspected on this visit. Records seen were to a satisfactory standard. Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x x 2 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Iona Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 3 x x x 3 x E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 23 yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. Standard 24 20 34 Regulation 23 13(2) 19(4) Requirement Timescale for action 2 weeks. Carpeting to be replaced in shared room as identified in last report. -Timescale not met All staff administering medication 30.9.05 must have accredited training. CRB checks must be obtained for Ongoing all staff prior to employment. 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 Good Practice Recommendations Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Iona E51-E09 S4962 Iona V241147 250705 Stage 4.doc Version 1.40 Page 25 - 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. 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