Inspection on 01/11/07 for Livability

This inspection was carried out on 1st November 2007.

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

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Tudor Way 35 Tudor Way Brackley Northants NN13 6NH Lead Inspector Kathy Jones Unannounced Inspection 1st November 2007 07:45a Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 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 Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 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. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Tudor Way Address 35 Tudor Way Brackley Northants NN13 6NH 01280 843957 01280 840049 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) www.grooms-shaftesbury.org.uk Grooms-Shaftesbury Ms Jill Lammond Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. A maximum of three (3) service users in the category of LD may be accommodated in the home at any time. No one in the category of LD may be admitted to the home when three (3) service users in this category are already resident. Not applicable as new registration. Date of last inspection Brief Description of the Service: Tudor Way is a care home, which is registered to provide personal care and accommodation for three people with a learning disability. The service is one of six homes in the area, which were owned by the Shaftsbury Society until June 2007 when they merged with John Grooms. The owners are now Grooms – Shaftesbury. Tudor Way is situated in a residential area of Brackley in Northamptonshire. The home is within walking distance of Brackley Town Centre where community resources include shops, pubs, restaurants, gymnasium and a swimming pool. All the residents have single bedrooms and share a lounge and kitchen/diner. There is also a well-maintained garden. The Registered Manager, who is also Registered Manager for Hawkins Close and Westminster Croft, has an office base at Tudor Way. Fees are dependent on the level of support required and currently range from £773.83 to £778.00 per week. Fees include accommodation, food and personal care and support. Additional costs include newspapers, clothing, toiletries and activities and holidays. Information about the services provided is included within the statement of purpose and service user guide. This is the first inspection under the current registration, however when published the inspection report will be made available with the service user guide. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Standards identified as ‘key’ standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The pre-inspection planning was carried out over the period of a day and involved reviewing the service history, which details all contact with the home including notifications of events reported by the home, telephone calls and any complaints received. The information reviewed has been taken from the date of the current registration, which was June 2007. The unannounced inspection visit covered the afternoon of a weekday. The inspection was carried out by ‘case tracking’, which involves selecting samples of residents’ records and tracking their care and experiences. Observations of the homes routines and care provided were made and the inspector spoke with residents before they went out for their day activities about the support that they receive. Staff were also spoken with to ascertain their views on the service provided. In addition information received following the inspection in surveys completed by three staff members has been taken into account. The management of a sample of residents’ medication was checked. And a sample of staff files, which are held at Tudor Way were reviewed to check the adequacy of the recruitment procedures in safeguarding residents’. Verbal feedback was given to the Registered Manager throughout the inspection. What the service does well: There is an experienced staff team who appear committed to meeting the needs of residents. Residents were obviously comfortable and relaxed in the presence of staff and had developed good relationships with them. Routines within the home are flexible and based around residents’ individual choices and commitments and Tudor Way is treated as the residents’ home by staff. Staff work with residents to provide them with support to meet their individual needs and they seek advice from relevant health professionals where appropriate. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 6 Residents are encouraged to take responsibility and have some independence in their daily routines. Residents talked about their work and social lives and expressed general satisfaction with their daily lives and the level of support that they receive from staff. 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. The summary of this inspection report can be made available in other formats on request. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 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 Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process provides assurances that the needs of people admitted to the home can be met. EVIDENCE: There is a statement of purpose and service user guide, which provides information about the service provided for prospective and existing residents’ and their families. A pictorial version of the service user guide is also available for residents’ if required. It was identified that information about the fees is not included within the service user guide. Advice was given about the need to include clear information about fees and additional charges to ensure people understand what the fee covers and what additional costs they are likely to have. At the time of the inspection there were no vacancies in the home, however it was established that if there were to be a vacancy there is a thorough admission process. The admission process involves an assessment of needs and several visits to the home to establish if the prospective resident’s needs Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 9 can be met and to allow them the opportunity to decide if they want to move in. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are supportive of residents’ individual needs and choices, however improved record keeping would help in tracking individual progress in achieving agreed goals. EVIDENCE: The staff team is relatively stable and residents are generally cared for and supported by staff that know them and their needs very well, providing good outcomes for residents. A sample check of a residents care records identified that care plans which identify and provide clear information about their care and support needs are in place. The care plans had been developed with the involvement of the resident and a document entitled “This is me” provides a very good overview of their needs, preferences and routines. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 11 There was evidence that care plans are reviewed. Advice was given to include clear information within the review about progress in meeting aims/goals. The ability to track residents’ individual progress in achieving agreed goals is important to ensure that support strategies can be reviewed and revised if necessary. Surveys received from three staff members who work with residents in three of the houses owned by Grooms-Shaftesbury in Brackley confirmed an understanding of their responsibilities for ensuring that they were aware of residents individual needs. Discussion with staff confirmed that they are aware of the importance of supporting residents in making decisions in their daily lives as individuals and also as a group. House meetings are held weekly and issues relating to the running of the house are discussed and agreed. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to lead a lifestyle, which meets their needs and preferences. EVIDENCE: Residents indicated that they were satisfied with their daily lives and are supported to have some independence. They have various day time activities/occupation. One resident said that they work in a local bookshop and another works at the local supermarket for two days a week. All residents have the opportunity to attend the Links day centre, which provides various activities. Grooms-Shaftesbury runs the day centre for residents from several care homes. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 13 Discussion with one resident identified that they take an active part in the local community, and an interest in affairs, which affect the local community. They also confirmed that they are able to attend religious services in accordance with their faith. Review of a residents records indicated that they had good social and leisure opportunities. Activities included, walking, swimming, visiting friends and having friends home for tea. Residents told the inspector that there had been a Halloween party at the house the night before the inspection with residents from the other five houses in Brackley being invited. Residents had clearly enjoyed decorating the house for the party and discussion indicated that staff had worked hard to make it an enjoyable event. Information received in the annual quality assurance assessment (AQAA) and inspection of three other homes, which are owned by the same organisation, has identified that there are currently some difficulties, which affect residents’ social activities. The difficulties relate to transport and the fact that there is only one member of staff on each shift, which can limit residents’ opportunities. A discussion with managers during the inspections and information received in the AQAA’s when collated indicates that action is being taken to address these issues. Records and discussion with residents identifies that residents’ rights are respected and that they are encouraged to take some responsibility and have some independence in their daily lives. Discussion with staff and residents confirmed that staff understand the importance of supporting residents where possible to maintain good links and relationships with families and friends. Discussion with the Registered Manager identified that staff may benefit from some specific training to help them support residents appropriately with personal relationships. Residents’ said that they have choice with their meals and that the menus are planned with them on a weekly basis. Residents are encouraged to be involved in shopping for food and to take responsibility for some of the domestic tasks, which are part of daily life. For example on the morning of the inspection a resident who had a day off that day was doing their washing prior to going out to the shops. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents receive good care and support with health care services being accessed as appropriate. EVIDENCE: Care records demonstrate that residents are supported to access health care services such as dentist, optician and chiropody. Appointments and advice are sought from health care professionals as required such as General Practitioner, Consultant psychiatrist and the Community Learning Disability Nurse helping to meet physical and emotional needs. Discussion with the Registered Manager around how the needs of residents are met and how residents’ rights are protected confirmed that advice is sought where necessary and appropriate from relevant professionals. Review of a resident’s records identified that there was a health action in place and that they are encouraged and supported to be involved in and to take some responsibility for managing their health. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 15 Discussion with staff indicated that they are aware of the individual health care needs of residents and support residents in acting on the advice from health professionals. Residents’ medication is well managed and securely stored. Staff spoken with, were mindful of the need to ensure that the procedures in place for the safe administration of medication are followed and that any discrepancies are reported to the Manager. It is important to ensure procedures are in place to ct on any errors to ensure that residents are not put at risk. However advice has been given to consider if it is necessary to make a safeguarding adults referral in all instances, as it may be more appropriate in some circumstances to deal with the problem through the staff supervision and training process rather than safeguarding adults. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a positive approach towards complaints, which helps residents to raise concerns and provides good safeguards. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service. Review of the annual quality assurance self assessment (AQAA) and discussion with residents and staff confirms that residents concerns are taken seriously and acted on. Surveys received from three staff members and discussion during the inspection confirms that staff are aware of their responsibilities for safeguarding the people in their care and reporting any concerns that they may have. Discussion with the Registered Manager confirmed that she is aware of the process for reporting any concerns through safeguarding adults’ procedures to ensure that residents are properly protected. It was identified that the organisations procedures require completion of a protection of vulnerable adults referral for all medication and medication errors regardless of risk. Advice has been given to consider whether it is necessary to make a safeguarding referral to social services and notify the Commission for Social Care Inspection in cases where it was clear that a resident had not been Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 17 placed at risk. It is of concern that overuse of the procedures may lead to incidents not being taken sufficiently seriously. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s live in a home that is comfortable and homely. EVIDENCE: The home is of domestic layout and is situated in a residential area within easy travelling distance to the town centre and local community resources. All areas were clean, tidy and reasonably maintained. The annual quality assurance self assessment identifies that there is a maintenance plan which identifies and addresses areas for improvement. The three resident all have single rooms. Residents spoken with were happy with their home. They confirmed that they are able to spend time with the other residents in the shared lounge or in their own room and observations identified that they all have their individual routines. Staff understand the importance of respecting residents right to privacy and to be able to spend time in their own rooms if they wish. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 19 There is a well maintained garden, which is planted and looked after by staff and residents. The Registered Manager who manages three small homes in the area has an office at Tudor Way. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training and recruitment procedures provide good care and protection for residents. Staffing levels need to be kept under review to ensure that residents’ needs are fully met. EVIDENCE: There is a stable staff team and although some of the staff are agency staff the same agency staff are used to provide consistency for residents. The annual quality assurance self assessment identifies that recruitment will be an ongoing process until a full permanent staff team is established. Surveys received from three staff members following the inspection, support views of staff through inspection of the other houses that staffing levels can impact on the leisure activities of residents. This is clearly an area that needs to be kept under review to ensure that residents’ needs are met. Residents spoken with were happy with the staff that support them and had no concerns about how staff speak to or treat them. Discussion with residents and Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 21 staff identified that staff had worked hard in organising a Halloween party held in the home the night before the inspection. Observations during the inspection confirmed good relationships between staff and residents. Staff spoken with presented as caring and knowledgeable about the needs of individual residents. The agency staff used are all familiar to the residents having in some cases worked in the home for a few years. Surveys received from three staff members and discussion on inspection confirmed that new staff receive induction training and that they receive training appropriate to meeting the needs of residents. The information in the surveys identifies that there is a process through regular supervision sessions with the manager, of identifying specific training needs. The information also indicates that staff acknowledge the need to look at their own training needs. Discussion with the Registered Manager confirmed that training needs are considered in relation to the needs of the individuals and that where required specific training is provided. For example she was going to make enquires about arranging training for staff to help them to support residents with personal relationships. A survey received from a member of staff identified that training in Autism is also currently needed for the staff team. Staff files were sample checked during the inspection at Tudor Way. The same staff team work at Tudor Way, Hawkins Close and Westminster Croft. Review of the recruitment process for a recently recruited member of staff confirmed that criminal record bureau clearances and references had been obtained prior to staff working in the home helping to protect residents’. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managed in a manner that promotes and safeguards the health, safety and welfare of residents’. EVIDENCE: The Registered Manager has several years experience of working with the client group and appears committed to providing good care and support for residents. Discussion with the Registered Manager identified that she had been away on sick leave for a period of five weeks. CSCI received no notification of this or of the arrangements for managing the home in her absence. Under the Care Homes Regulations 2001 there is a requirement that CSCI are informed of any Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 23 absence of a registered person including a registered manager over 28 days. The role of the registered people is considered to be particularly important in relation to the welfare of residents as they hold the legal responsibilities. An annual quality assurance self assessment (AQAA) was submitted to the Commission for Social Care Inspection (CSCI) prior to the inspection. Review of the information indicates that that there is an awareness of the need to carry out an ongoing review of the support provided to residents to ensure that their needs and expectations are met. Unannounced visits are carried out each month by the Area Manager to monitor the quality of care provided. Discussion identified that each month there is a different focus to the visit and that checks are made as to how well the home is meeting the National Minimum Standards. No health and safety concerns were identified during the inspection. Records and discussion with staff confirm that appropriate training in safe working practices is provided for staff such as first aid, movement and handling and fire safety. This helps to reduce the risk to residents. Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 24 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 2 2 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 25 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. Refer to Standard Good Practice Recommendations Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Tudor Way DS0000070267.V353999.R01.S.doc Version 5.2 Page 27 - 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. 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