Inspection on 04/07/06 for Milverton Road Care Home

This inspection was carried out on 4th July 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 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Milverton Road Care Home 30/03/09

Milverton Road Care Home 04/07/07

Milverton Road Care Home 05/10/05

Milverton Road Care Home 13/10/04

Milverton Road Care Home 19/04/04

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 Milverton Road Care Home 70-74 Milverton Road Bestwood Park Nottingham NG5 5RH Lead Inspector Joanna Carrington Key Unannounced Inspection 4th July 2006 09:30 Milverton Road Care Home DS0000002254.V301253.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 Milverton Road Care Home DS0000002254.V301253.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. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Milverton Road Care Home Address 70-74 Milverton Road Bestwood Park Nottingham NG5 5RH 0115 916 0720 0115 916 0748 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.mencap.org.uk Royal Mencap Society Ms Faye Wyndham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for Learning disability (LD) - 6 Date of last inspection 5th October 2005 Brief Description of the Service: Milverton Road is a small home for adults with learning disabilities. Care and support provided by Mencap in rented premises, owned by New Era Housing Association. The detached property has been converted from three terraced houses. It is not accessible to wheelchair users. The home is sited within a residential community with access to a variety of local facilities and is within walking distance of Arnold town centre. Alternative communication methods are used with most service users and varying support is given to enable individuals to maintain some independence. The fees are £317.22 per week. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over six hours on 4th July 2006. This was the home’s key inspection for this financial / inspection year. The main method of inspection was called ‘case tracking’ which meant selecting three service users and tracking the care and support they receive through checking their records, observation of care practice and discussion with staff. Two of the three service users were spoken with. Staff records were looked at and a partial tour of the premises also took place in order to assess environmental standards. Three staff members were spoken with and the manager was available for discussion and feedback throughout. Overall the inspection found there to be very positive outcomes for residents. What the service does well: Prospective service users do not move to the home until their needs have been assessed and there has been opportunities for them to be introduced and ‘test drive’ the home. Care plans and risk assessments are thorough and provide detailed information on how service users’ needs are to be met. Step-by-step guidance is provided on how to support service users with their personal care and individuals’ preferences are included, which is good practice. It is evident that staff are committed to promoting choices and enabling communication with service users. Specialist health and social care professionals are accessed when necessary to help in meeting the needs of service users. Service users have good opportunities to participate in meaningful and fun activities both in the home and in the community. Service users are supported to maintain contact and relationships with family and other significant people. There is an appropriate complaints procedure in place, to ensure that residents and their representatives’ views are listened to and acted on. To assure that residents are safeguarded from abuse the Nottinghamshire Policy and Procedures are adhered to. Training and support for staff is good, which ultimately the residents’ benefit from. Recruitment practices ensure the protection of residents. The environment is kept and generally maintained to a good standard. There is plenty of communal space for service users and it is homely throughout. There are systems in place for quality monitoring which ensures the home is run in the best interest of service users. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 6 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. Milverton Road Care Home DS0000002254.V301253.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 Milverton Road Care Home DS0000002254.V301253.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 4 and 5 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is a robust admissions procedure in place, which ensures that the home is suitable in meeting the needs of prospective service users and there is now enough information available for prospective service users to make an informed decision about moving to the home. EVIDENCE: For all three service users case tracked each had a copy of the placing authority’s community care assessment on their file. This information is essential in initially deciding whether the home would be suitable in meeting that individual’s needs. The service user that has most recently been admitted to the home had a series of introductory tea visits and day visits before they moved to the home. This time also helped the current residents get to know their new fellow housemate. The requirement to update the Statement of Purpose has now been met. This has now been updated and includes all the necessary information about the home. All service users have a tenancy agreement, of which the content complies fully with the regulations. There is also a basic guide to the tenancy agreement in pictures so the information is more accessible. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 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, 7 and 9 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. There are good arrangements for ensuring that needs and choices are met, but developing support plans for the new service user is overdue. Risks are assessed and independence is encouraged with support given where needed. EVIDENCE: Two of the three service users case tracked had excellent comprehensive support plans in place covering all aspects of heath, personal and social care needs. These are written in the first person, which supports the fact that service users’ own their respective care plan and the information in it. The format also uses pictures to make the information more accessible to service users. There was evidence that the care plans are reviewed on a three to six monthly basis and there are also annual review meetings. One service user had theirs at the day centre on the day of the inspection. The service user that was admitted last October still only has temporary support plans in place. Although this information is still relevant these are not as comprehensive and as well presented. The registered manager reported that she is in the process of writing them. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 10 Staff spoken with explained the communication needs of certain residents, which were reflected in their respective support plans. Support plans make reference wherever possible to enabling residents to make choices and when asked, staff spoken with gave good examples of how this can be achieved, for example, using pictures, photos, actual items and signs. Issues of risk are an integral part of support plans and clearly identify when restrictions are necessary. For example, having to be accompanied in the community due to poor road safety awareness. There are also accompanying risk assessments that have been put into place that enable service users to be more independent. For example, taking a taxi to the local gateway club. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 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): 12, 13, 15, 16 and 17 Quality for this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. There is a commitment from the staff team in promoting residents’ rights and enabling residents to experience a fulfilling quality lifestyle. EVIDENCE: All of the service users attend day services and participate in activities appropriate to their individual needs. On the day of the inspection one service user that had a medical appointment went out for lunch with staff. It was evident from speaking with staff that going out and spending meaningful time with service users is a fundamental element of their support role. A staff member was observed playing a game with a service user, which he appeared to enjoy. One service user said that he enjoys going down the pub with his keyworker and going out for walks. All of the service users are growing their own chosen plants in the garden and are also in the process of a sunflower competition. Staff spoken with gave good examples of how they assist service users in maintaining contact and relationships with family and friends. Family and friends are invited along to their birthday parties and staff will facilitate phone calls and transport service users to see family. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 12 Support plans make reference to respecting individuals’ privacy and dignity and staff were seen to be interacting with service users in a respectful manner, not just exclusively with each other. Service users are encouraged to help out with domestic duties such as cooking and cleaning their bedrooms and any responsibilities are identified in their respective support plans. Menu plans and records show that varied and healthy meals are provided to service users. On the day of the inspection there were two choices of chilli con carne and pizza and salad. Service users appeared to look forward to and enjoy their mealtime. It is recommended that, in case of food poisoning that a record is kept of who has had what meal. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 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, 19 and 20 Quality for this outcome area is excellent. This judgement has been made using available evidence including a visit to the service. The health and personal support needs of residents are well met and overall medicine management is safe. EVIDENCE: Specialist health and social care professionals such as psychiatrist, dietician and occupational therapists are involved in residents care when appropriate. Appointment records show that service users have annual health checks and access to primary healthcare services when needed. Support plans provide detailed step-by-step instructions on how personal care is given to residents, which include their individual preferences. For example, liking lie-ins and specific routines. Service users spoken with said they choose when they go to bed and get up. Medication Administration Records appear well kept, no errors were found with administration of medicines. Current medication is listed in individual support plans. There is clear additional information available to staff regarding each medication. It is recommended that when medicines are not supplied in a month (if ‘as required medication for example) then the quantity remaining from the previous Medication Administration Record (MAR) be carried over onto the next MAR. This is so that there is an audit trail of drugs and a clear account of what quantity is in the home. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. There is an appropriate complaints procedure in place, to ensure that residents and their representatives’ views are listened to and acted on. The Local Adult Protection Procedures are appropriately followed, which helps to assure that residents are safeguarded from abuse. EVIDENCE: A social worker is involved with one service user that had made an allegation but this concerns the day centre and not the home. Staff spoken with confirmed that they have had training in adult abuse and demonstrated an understanding of their role and responsibilities in terms of whistle blowing and in accordance with the local adult protection procedures. Arrangements are in place to protect service users from financial abuse with the use of individual financial plans. The transaction records and system for handling service users money appeared to be in order. Service users keep a locked money tin in a safe in their own bedrooms. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 26 and 30 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, safe and comfortable home but would benefit from some parts being updated. EVIDENCE: On a tour of the premises it was apparent that the home is kept homely for the service users, with plenty of communal space including a lounge, large dining area and a quiet / activity room. There is also a nice garden at the back for service users to access. Service users’ bedrooms are personalised in their favourite colours and with their own items and pictures etc. The laundry facilities are appropriate to the needs of the residents. The registered manager reported that the home is in the process of employing a cleaner for the first time so that staff can concentrate more on providing support and quality time to service users. The home appeared clean throughout although the bathrooms floors have an unclean look to them. The recommendation to replace the flooring is now outstanding. This recommendation is now extended to updating the bathrooms, as the fittings are old with signs of rust on them and paint is coming off the wall in parts. The requirement to repair the washbasin in one of the bathrooms has now been met. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 16 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, 34, 35 and 36 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. Staffing levels are appropriate to the needs of service users and training and support for staff is well managed, which service users ultimately benefit from. Recruitment practices protect service users. EVIDENCE: The home is well on its way to achieving 50 of the staff team being qualified to at least a National Vocational Qualification (NVQ) level 2. There are six staff members currently in the process of doing their NVQ with two of the six trialling the joint NVQ 2 and Learning Disability Award (LDAF) level 2. Staff spoken with confirmed that training opportunities are good and that as well as attendance of mandatory courses there is also specific training relevant to the individual and collective needs of service users. This was evident in training records. Staff said they feel supported by the manager and on staff files there were copies of supervision records. There was also evidence of two written references and a Criminal Record Bureau disclosure on three staff files looked at. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 17 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): 37, 39, 41 and 42 Quality for this outcome area is good. This judgement has been made using available evidence including a visit to the service. The health, safety and welfare of service users are promoted and protected. The home is well run and systems for monitoring the quality of care are in place, to ensure the home is run in the best interest of service users. EVIDENCE: The home receives a full service review from the provider Mencap every three years. On an annual basis service user surveys are distributed. These are presented with pictures so they are more accessible to adults with a learning disability. The registered manager will visit another Mencap home while another manager visits Milverton Road, to chat with service users and audit care practice issues. A file has been set up to include a ‘Service Improvement Plan’ as a result of quality monitoring and feedback. The provider also carries out monthly visits in accordance with Regulation 26 of the Care Home Regulations 2001. The registered manager must ensure that any event in the care home which adversely affects the well-being or safety of any service user, is notified to the Commission in accordance with Regulation 37 of the Care Home Regulations Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 18 2001. There were a couple of incident records regarding criminal damage by the general public including a cracked bedroom window. The fire log shows that all necessary fire safety testing and drills have been carried out. The servicing of equipment and electrical and gas systems are all up to date. As recommended at the last inspection there is now a central management record of all accidents and incidents that have occurred in the home and there is now a risk assessment in place for lone working in the community that identifies precise action to take in the event of an emergency situation. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 3 5 4 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 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 2 x 3 X 3 X 2 3 X Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 20 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. 2. Standard YA6 YA41 Regulation 15 37 Requirement Complete comprehensive support plans for service user admitted in October last year. Notify the Commission of any event in the care home which adversely affects the well-being and safety of service users. Timescale for action 30/08/06 04/07/06 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. 2. 1. Refer to Standard YA17 YA20 YA27 Good Practice Recommendations Record who has had what meal- to track back in case of food poisoning. Ensure all medicines in the home are accounted for and can be audited by carrying over left over medicines onto the next Medication Administration Record. Update both bathrooms. This also includes replacing the flooring, which is the recommendation made in the previous report. Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Milverton Road Care Home DS0000002254.V301253.R01.S.doc Version 5.2 Page 22 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!