Inspection on 05/10/05 for Milverton Road Care Home

This inspection was carried out on 5th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 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 04/07/06

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 Meryl Bailey Unannounced Inspection 5th October 2005 02:00 Milverton Road Care Home DS0000002254.V255963.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 Milverton Road Care Home DS0000002254.V255963.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. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 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) Royal Mencap (Housing & Support Services) Ms Faye Wyndham Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Registered for Learning disability (LD) - 6 Date of last inspection 20th May 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. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and conducted by one inspector during one afternoon. All five current service users arrived home from day services and two staff were seen in addition to the manager. Two student nurses were also present. There was one current vacancy about to be filled by a prospective service user. No visitors were present on the day of this inspection. The communal areas of the home were inspected. Relevant records were sampled and inspected relating to service users and staff. Views of service users were obtained to some extent from interaction and observations. Not all standards were assessed on this occasion as many key standards were met or exceeded on the last inspection. 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. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 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 the following standard(s): 1 and 2 Information about the service is available to service users, but some detail still needs to be added. Individual needs are comprehensively assessed EVIDENCE: As at the last inspection the Statement of Purpose document and the Service User Guide were not finalised as the sizes of bedrooms have not been included and amended versions have not been issued. However, the existing service User Guide gave some clear information. Comprehensive assessment material was found on the file prepared for the new service user who was due to move in within the next two weeks. He had made some day visits and then stayed for one week to test out the service. A provisional support plan was drawn up and records were kept of his stay. The manager explained that other service users were observed in their interaction with him and all have agreed for the move to take place. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 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 the following standard(s): None of these standards were assessed on this occasion as the key standards were found met at the last inspection. EVIDENCE: Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 9 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 Service users’ rights are respected and they are offered a choice of wellbalanced meals. EVIDENCE: All service users have been offered a key to their rooms and have each kept a key for their locked cash box. Staff primarily interacted with service users and not each other and service users could choose where they wanted to be within the premises. There were no restrictions in moving around the home and gardens. Privacy was respected. There was a week’s menu displayed in the kitchen, showing a variety of well balanced meals and support workers prepared the cooked meal in the evening. During the inspection three service users chose sausage hot pot and two went out for a pub meal. Choices were made with the assistance of pictures and photographs. A packed lunch was provided for each service user to take to day centre. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 10 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): None of these standards were assessed on this occasion as they were met at the last inspection EVIDENCE: Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 11 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 There is a clear procedure for investigating complaints. Service users a protected from abuse. EVIDENCE: There is an adapted Mencap complaints procedure made available to service users. Forms are available for recording complaints, but none have been received. A record book was seen which is kept for anyone to record concerns and compliments. No concerns were recorded, but thank you cards had been placed in the book. Since the last inspection amendments have been obtained for the Area Adult Protection Policy and Procedure and the manager has booked training provided by Nottinghamshire Adult Protection Unit for 5th December 2005. Staff have continued to undertake a training module “Protect Me from Abuse” as part of their foundation training. Arrangements were in place to protect service users from financial abuse with the use of individual financial plans. All cash was kept securely and counted daily. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 12 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, 27 and 30 A homely comfortable environment is maintained with the exception of some minor structural maintenance in a bathroom. All areas are clean and hygienic. EVIDENCE: Decorating was in progress externally and also internally in the hallways and stairs. Service users had been consulted regarding decorating colours. There were also plans for the kitchen to be totally refurbished commencing 7th November 2005. Additional electric sockets had been fitted in the large lounge as required at the last inspection. All communal areas appeared clean and tidy, with good quality homely furnishings. The rear garden had been improved with raised flowerbeds, new fencing and large seating area. Bathrooms and toilets were clean, but a washbasin support leg, which was found damaged at the last inspection, had been removed but not replaced. The manager stated that this had been reported to the landlords for repair. Bedrooms were not viewed on this inspection, but see under Standard 1 where it is recommended the limitations are made clear in the Statement of Purpose and Service User Guide. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 13 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 Service users are supported by a committed team of staff who are continually developing their skills and knowledge. EVIDENCE: Of the ten current support staff, one has completed National Vocational Qualification at level 2 and three have recently commenced this level. The other six staff are continuing with Foundation Training with Mencap. This is comprehensive and accredited within the Learning Disability Award Framework. Staff are given paid time to undertake their training whilst service users are at day services. Staff were observed interacting with service users and full respect was given. One staff member was very experienced with caring for people with learning disabilities. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 14 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 and 42 The service is run by a manager who is keen to develop management skills. Service users views are sought where possible. Health and safety within the premises is generally promoted, but some further action is recommended. EVIDENCE: The manager has recently been assessed and registered with the Commission. She has so far successfully passed five units of the National Vocational Qualification in Management and is well on the way to completing the second half of the training. There was no clear development plan for the service. Quality assurance questionnaire forms were completed earlier in 2005, when a manager from another Mencap home was involved in assisting service users to express their views. These views were taken into account and action taken for example one person wanted use of a digital camera and this has been actioned. However, three monthly house meetings with all service users have not continued. The manager said that this was due to the difficulties with communication within a meeting. Alternative methods of sharing views regularly should be explored. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 15 There were records of training in moving and handling, first aid and fire training for all staff. Infection Control and Food Hygiene was covered in induction training. Fire safety notices are supplemented with Makaton drawings. Staff have had induction training in medication, followed by further direction from a pharmacist. Dates have been booked later in October 2005 for accredited training in Medication with Boots. There were written risk assessments covering various tasks undertaken by staff, including lone working. Staff work alone in the community with service users and within the home. It is recommended that precise action to take in the event of an emergency be specified. Accidents are recorded on incident forms, which are submitted to the Mencap service manager with copies placed on individual files. It is recommended that a management file be kept securely of all such forms and that the manager ensures appropriate action is followed up. There was one accident recorded for a service user who sustained a head injury and NHS direct were consulted, but there were no records of any observations or follow up actions taken. The Commission should also be notified under Regulation 37 of any accident or injury requiring the need to contact an outside agency. Milverton Road Care Home DS0000002254.V255963.R01.S.doc Version 5.0 Page 16 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 2 3 X X X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X 2 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 X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Milverton Road Care Home Score X X X X Standard No 37 38 39 40 41 42 43 Score 3 X 2 X X 2 X DS0000002254.V255963.R01.S.doc Version 5.0 Page 17 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA1 Regulation 4, 5 Requirement The Statement of Purpose and Service User Guide must be fully amended. Copies to be sent to the Commission. Ensure the washbasin is repaired or replaced. Previous target of 30/06/05 was not met. Notify the Commission of any accident or injury requiring the need to contact an outside agency. Timescale for action 31/10/05 2 3 YA27 YA42 23(2) 37 30/11/05 05/10/05 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 3 4 Refer to Standard YA27 YA39 YA42 YA42 Good Practice Recommendations Replace the flooring in both bathrooms. Compile a development plan to cover all areas of the service reflecting aims and outcomes for service users. In written risk assessments, specify precise action to take in the event of an emergency when staff are working alone in different situations. Keep a management file of accident forms and ensure appropriate action is taken and recorded following accidents. DS0000002254.V255963.R01.S.doc Version 5.0 Page 18 Milverton Road Care Home 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. 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