Inspection on 18/08/05 for King Street (57)

This inspection was carried out on 18th August 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

King Street (57) 04/03/09

King Street (57) 08/03/07

King Street (57) 09/02/06

King Street (57) 13/01/05

King Street (57) 15/07/04

King Street (57) 18/03/04

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

CARE HOME ADULTS 18-65 King Street (57) 57 King Street Melksham Wiltshire BA14 9AE Lead Inspector Alyson Fairweather Unannounced 18 August 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. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service King Street (57) Address 57 King Street Melksham Wiltshire BA14 9AE 01225 707669 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) ABLE (Action for a Better Life Beverley Pollitt Care Home 6 Category(ies) of MD Mental Disorder registration, with number of places King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 13th January 2005 Brief Description of the Service: 57 King Street is one of a number of homes run by an organisation called ABLE (Action For A Better Life). Knightstone Housing Association owns the property, and the day-to-day registered manager is Ms Beverley Pollitt. The home provides a service for 6 service users who have or are recovering from mental illness. It is situated within short walking distance of Melksham town centre and transport is available to take service users to day centres as required. The house has a number of communal rooms, a patio area and a large enclosed garden. There is some parking to the rear of the house. Service users have their own bedrooms and one room has an en-suite bathroom with a shower. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in August. There were several residents at home, as well as the manager and three care staff. The inspector would like to thank the residents for spending time chatting and showing their photographs. Records examined included care plans, staff files and training records. 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. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 6 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 King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 7 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) 2 and 4 Prospective service users have their needs, hopes and goals assessed and recorded before they move in to the home so that staff know how best to support them. They can visit the home before they move in to see if it is the right place for them. EVIDENCE: No new residents have been admitted to the home for a number of years, although there is a standard assessment procedure which would be used if this was to happen. An application form would be completed by the referring mental health team, detailing the potential resident’s background history, skills and activity levels. The manager would also meet with prospective residents and complete the home’s own assessment form. A visit to the home would be encouraged if it was thought that they could meet the person’s needs, and admission would be on the basis of a month’s trial. A meeting would be arranged at the end of the trial period to monitor the placement and a future care plan review meeting date would be set. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 8 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 and 7 Care plans reflect the needs and personal goals of respite guests, which means that staff are able to support them in the way they wish. They are supported and encouraged to make their own decisions. EVIDENCE: Each resident has a care plan which is reviewed on a monthly basis by the resident and their key-worker. Care plans focus on individual’s strengths as well as any need or problem, and contain sections on communication abilities, domestic abilities, mental health, physical health and sleep patterns, among others. Residents have the opportunity to record their comments on the reviewed care plan. A daily dairy is also kept for each resident, and this records what they have done during the day. Each resident also has a care plan meeting (CPA) on a regular basis with the local Community Mental Health Team (CMHT). While staff at King Street take great care to make sure that residents sign and agree the home’s care plans, it was disappointing to note that the ones sent to the home by the CMHT have no resident signature. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 9 Residents who were spoken to said that they were supported by staff to make their own decisions, and that they were encouraged to manage their own finances where possible. There are weekly residents’ meetings and part of the meeting involves choosing the meals for the following week and also discussing any trips they want to go on. Three residents now go to meetings on a regular basis with the Trustees of ABLE, and all residents meet potential staff when they come for interview. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, and 15 Social and leisure activities are varied and tailored to individual need, with residents choosing what they wish to do. Residents can have as much or as little contact with family and friends as they wish, and are supported to do so by staff. EVIDENCE: Residents have access to a range of community activities. These include attending college, an industrial therapy workshop and attending drop-in centres to meet with community psychiatric nurses. One person helps out in a shop and two attend night school. Gateway clubs, further education colleges, and industrial therapy workshops. People also attend local churches. Some residents have short breaks away and others have longer holidays. Two residents had recently returned from the Channel Islands, and described their first ever flight. They were delighted to show photographs of this and previous holidays. Both said that they had been supported in booking the holiday and flights by staff. Another had been on a short holiday to a local respite service. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 11 Friendships both inside and outside the home are encouraged, and staff support links between residents and their family and friends, although the frequency of contact varies depending on the individual circumstances. Residents are free to visit friends outside the house at any time, and can entertain and choose to see who they like either in the privacy of their own bedrooms or in the communal areas available. One resident had attended a family wedding, and was planning a return trip. Another visits his parents fortnightly, and they in return are invited to lunch at the home on a regular basis. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 Healthcare needs of residents are written in care plans so that they can receive support in the way they need and prefer. EVIDENCE: All residents are registered with a GP whilst living in the home, and all other medical professionals are seen as and when required. This varies according to the needs of individuals. The home has good links with local mental health teams, and can call for support if any crisis periods arise. All residents attend mental health reviews on a regular basis, and care plans can be amended at this time. One resident has had physical problems with an injured leg, and staff have supported all the GP and hospital appointments needed. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 13 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) 23 The policies and procedures the home has in place try to ensure that residents are safeguarded from abuse and harm. EVIDENCE: The home has copies of the “No Secrets” document, as well as the organisational policy and procedure on responding to allegations of abuse. All staff members have received Vulnerable Adults training, and all are encouraged to report any incidences of poor practice. A “Whistle Blowing” procedure is also available for all staff, and risk assessments are in place for all residents. All staff have Criminal Records Bureau (CRB) checks and are checked against the Protection of Vulnerable Adults (POVA) register. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 14 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 and 30 The care which residents and staff take to maintain the home means that residents live in a homely, comfortable safe environment, which is clean and hygienic. EVIDENCE: King Street is an attractive home, with two lounges, a dining room and a big, domestic style kitchen. It is light and airy, with comfortable furnishings. Each resident has their own bedroom, and these were homely and contained individual personal items. Everything was in good order, and new flooring was being laid. To the rear of the house is a large, secluded garden with attractive features. A new patio set had recently been purchased, and residents were sitting at this and enjoying the sunshine. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. The external driveway at the rear of the house has had the potholes filled in, although this could still benefit from having the surface evened out. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 15 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) 33 and 35 Residents are supported by an effective staff team. Their individual and joint needs are met by staff who have had induction and some specialist training, and are undertaking NVQ. EVIDENCE: One new member of staff was spoken to and was enthusiastic about the support she had had from both colleagues and the manager. She said that she felt able to ask questions if there were things she didn’t know and that everyone had been really helpful. A communications book is also used by staff, and this records any incidents and appointments made for residents. Staff spoken to were seen to be extremely well informed about the wellbeing of all the residents, and able to discuss any detail. There was a good rapport observed between residents and staff. Training for staff included safe medication handling, and infection control. Three members of staff are doing NVQ level 2 and two are doing NVQ Level 3. All staff have completed Vulnerable Adults training. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 16 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 Service users benefit from a well run home. EVIDENCE: The manager has completed her Registered Manager’s Award Level 4 in Care. Staff spoke warmly about the support and receive from the registered manager, and reported that the extremely approachable and that she was always happy to concerns or worries. and her guidance manager listen to NVQ they was any King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 17 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 3 x 3 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 King Street (57) Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 18 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. 1. Standard Regulation Requirement There were no requirements made at this inspection. 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 24 Good Practice Recommendations The registered provider should consider having the driveway at the rear of the house made level. King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 19 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire, SN15 2BB 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 King Street (57) D51_D01_S28382_KingStreet(57)_V181411_180805_Stage4.doc Version 1.40 Page 20 - 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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