Inspection on 09/02/06 for King Street (57)

This inspection was carried out on 9th February 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

King Street (57) 04/03/09

King Street (57) 08/03/07

King Street (57) 18/08/05

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 Inspection 9th February 2006 1:30 King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 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 King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 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. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 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 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) ABLE (Action for a Better Life) Beverley Pollitt Care Home 6 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (6) of places King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th August 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 residents who have or are recovering from mental illness. It is situated within a short walking distance of Melksham town centre although transport is available to take residents out 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. Residents have their own bedrooms and one room has an en-suite bathroom with a shower. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one afternoon in early February 2006. Several residents were spoken to, as well as the manager, two care staff and one relative. Written comments about the home have been received from five residents and four family members. The inspector walked round the premises and examined several records, including risk assessments, health and safety, the complaints procedure and staff training. What the service does well: What has improved since the last inspection? The premises have some recent re-decoration. New flooring has been laid in the dining room, and some of the home has been repainted. Carpets have been cleaned, a new radiator has been installed in the hallway and improved lighting has been installed on the top floor of the house. The external driveway at the rear of the house has had the potholes filled in, and has been tarmaced over, making it much safer for residents and staff who use it. One relative commented that “the house and staff are of a very high standard”. Staff have now stopped smoking in the house, and residents also frequently prefer to smoke outside, leaving a much cleaner, hygienic atmosphere . King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 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 King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 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. 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. This referral would include a copy of the current multidisciplinary care plan and any current risk assessments. 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) DS0000028382.V266799.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6 and 9 Care plans reflect the needs and personal goals of residents, which means that staff are able to support them in the way they wish. They are supported to take risks as part of an independent lifestyle. EVIDENCE: Staff have done a great deal of work to improve residents care plans. Each person 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). Each care plan is numbered and linked to any risk assessment required. Risk assessments were on file for all service users, and these are reviewed regularly. They included things like smoking, bathing and mobility. Risk assessments completed at CPA meetings are also on file. Staff place great King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 10 emphasis on encouraging residents to be as independent as possible, while trying to minimise any risk to their safety. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Residents’ rights are respected and their responsibilities recognised in their daily lives. Residents are offered a healthy diet and enjoy their meals and mealtimes. EVIDENCE: Residents can choose when to be alone or in company, and when not to join an activity. They have unrestricted access to the home and grounds, and can come and go as they please. One resident stays with his family every other weekend. One resident had gone out to his work placement on the day of the inspection, and one or two had gone out shopping, but the rest were at home. Staff enter residents’ bedrooms only with the individual’s permission, and were seen to knock on the bedroom door and wait for a response. Residents’ responsibility for housekeeping tasks, such as doing their laundry or tidying their room is specified in their care plan. One resident takes responsibility for feeding the house cats. Residents who are out all day open their own mail when they come home. One relative commented on the fact that staff had helped his relative have “security and confidence” and that he has “a good life of his own”. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 12 Residents are encouraged to be as independent as possible in the kitchen, and can prepare their own snacks, although staff support them when cooking main meals. Residents’ care plans outlined the support each person needed with this task. Healthy options are encouraged, and fresh vegetables, juices and yoghurts were available. Staff are aware of the differing health needs of residents, and support people with their low cholesterol and diabetic diets. One resident is vegetarian, and a lot of thought goes in to providing tasty and nutritious vegetarian meals. Menus are chosen by residents at their weekly meeting. There is a large, domestic style kitchen, with a dining room which is light and airy and comfortably furnished, so people can enjoy mealtimes. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 and 20 Residents receive personal care in the way they need and prefer. Residents are encouraged to self-administer medication wherever possible, and there are policies and procedures in place in relation to medication support. EVIDENCE: Although King Street is registered for people with mental health needs, some of the residents develop healthcare problems too, and at such times require personal support. Many of the residents require prompting, guidance and support in relation to personal support, although some direct physical care is sometimes needed. Personal care is offered in a sensitive and careful manner, with detailed care plans in place, outlining individuals’ preferences, and how their personal care is managed. All residents have their medication supplied in dossette boxes. New staff have medication induction training, and shadow an experienced member of staff until they are deemed competent. Some of the medication is delivered to the house by a member of the local CMHT, although can cause difficulties for residents at times, for example if no-one is at home. It is recommended that further attempts are made to have residents’ medication prescribed locally, so that people can be supported to pick up their own prescriptions, and further aid their independence. While examining the medication stock and records, it King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 14 was noted that some medication had been discontinued, and was not on the medication administration record, although it had not been returned to the pharmacy. The manager has been asked to ensure that all discontinued medication is returned according to the home’s medication procedures. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 Residents’ views are listened to, and any concerns are acted on. EVIDENCE: There is a complaints procedure in the home which outlines the steps to take if any one has a complaint. This gives details of how residents and families can contact the Commission for Social Care Inspection (CSCI) if they prefer to complain to an outside person. Regular residents’ meetings are held, and one resident said that if she has any concerns she can talk to staff. Staff spoken to were clear that they wished the service to be run in the interests of the residents. There have been no complaints made either to the home or to the CSCI. One relative commented that “the house and the staff are of a very high standard”. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 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 has been laid in the dining room. Some of the home has been repainted, carpets have been cleaned, a new radiator has been installed in the hallway and improved lighting has been installed on the top floor of the house. The external driveway at the rear of the house has had the potholes filled in, and has been tarmaced over, making it much safer for residents and staff who use it. The home was clean and hygienic, with policies and procedures in place for the maintenance of the building. Staff now no longer smoke in the house, and more residents are choosing to smoke outside. This has greatly increased the feeling of cleanliness and hygiene. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32 and 34 Residents are supported by competent and qualified staff, and they are protected by the home’s recruitment policies and practice. EVIDENCE: Three members of staff have done NVQ level 2, with another two working towards it. One is doing NVQ Level 3. All staff are booked to do a Mental Health Awareness course, and the manager is to investigate the location and costs of the Certificate in Community Mental Health for staff. Induction training for new staff members has included disability equality, infection control, and safe handling of medication. All prospective staff are invited to visit the home prior to being interviewed, in order to get a feel of the home and to enable staff to receive feed back from residents. The Manager and Responsible Individual then interview and two references are obtained. Staff complete a health questionnaire, and have a Criminal Records Bureau (CRB) check as well as a Protection of Vulnerable Adults (POVA) check. Whilst examining one staff file, it was noted that there was no record of a CRB check and no photo ID. The manager has been asked to ensure that all appropriate records are kept on staff files. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Residents’ views underpin all self monitoring and development in the home, although regular reports of senior managers’ visits would help confirm this. EVIDENCE: The home is subject to financial auditing both internal and external. There are regular staff meetings, reviews with community psychiatric nurses about individual residents, and annual reviews for all residents. Three residents attend the organisations meetings of the Board of Trustees. An annual resident questionnaire is sent out, and this is due to be issued again soon. The organisation has been awarded the Investors in People award. ABLE has an obligation to visit all their registered homes on a monthly basis and report on these visits to the Commission for Social Care (CSCI). Staff reported that they receive regular visits by senior managers of ABLE, and although some reports have been sent, these have not been sent to the CSCI on a monthly basis. The registered person has been asked to ensure regular King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 19 monthly visits to the home and to provide a copy of the report of these visits to the CSCI. The home has good fire safety policies and procedures in place. Water temperatures are tested on a weekly basis, and all staff have had food hygiene training, with food temperatures being recorded on a daily basis. One staff member takes responsibility for fire safety procedures, and provides training for the rest of the staff. The fire bell and emergency lighting are tested regularly. Fire extinguishers are serviced annually by an outside contractor, as are portable electrical appliances. Fire drills are held on a quarterly basis, with a record kept of all resident and staff who attended. It is recommended that the time taken to evacuate the premises is also recorded. King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score 3 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X 3 X 2 X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 King Street (57) Score 3 X 2 X Standard No 37 38 39 40 41 42 43 Score X X 2 X X 3 X DS0000028382.V266799.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 3 Standard YA20 YA34 YA39 Regulation 13 (2) 17 Schedule 2 26 Requirement All discontinued medication must be returned to the pharmacy. All staff files must contain evidence of CRB checks and photographic ID. Copies of the report of the monthly visits to the home must be sent on a regular basis to the CSCI. Timescale for action 09/02/06 09/04/06 09/04/06 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 YA20 Good Practice Recommendations Further attempts should be made to have residents’ medication prescribed locally, so that people can pick up their own prescriptions, and further aid their independence. The time taken to evacuate the premises during a fire drill should be recorded. 2 YA42 King Street (57) DS0000028382.V266799.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham 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) DS0000028382.V266799.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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