Inspection on 09/09/05 for Mount Road (104)

This inspection was carried out on 9th September 2005.

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

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Mount Road (104) 20/04/07

Mount Road (104) 05/01/06

Mount Road (104) 22/03/05

Mount Road (104) 25/08/04

Mount Road (104) 29/03/04

Similar services:

22 Sandown Road

The Highlands

Dilston College Of Further Education

West View House

Prince Bishop Court

Park View (15)

Craigmore House

1 Lanark Close

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

CARE HOME ADULTS 18-65 Mount Road 104 Mount Road High Barnes Sunderland SR4 7NN Lead Inspector Andrea Goodall Unannounced Friday, 9 September 2005 at 10.00 am The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Mount Road Address 104 Mount Road High Barnes Sunderland SR4 7NN 0191 522 8121 0191 522 8121 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Community Integrated Care Sarah Louise Loftus Care Home 3 Category(ies) of LD Learning disability (3) registration, with number of places B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 22 March 2005 Brief Description of the Service: The home at 104 Mount Road provides personal care and accommodation for up to 3 people with a learning disability. It began operating in 1989 and was later registered under the Registered Homes (Amendment) Act 1991. The care service is provided by CIC (Community Integrated Care). The house is the property of Three Rivers Housing Association, which remains responsible for general maintenance and repairs. The premises consist of a good-sized terraced house in a quiet residential area. It is close to a local shopping area, pubs and a bus service to the City centre. There is a small run of steps up to the front door so the home would not be suitable for people with significant mobility needs. On the ground floor there is a comfortable lounge and a dining room. At the back of the house is a large family sized kitchen/diner, a utility room with laundry equipment and access to the back yard. There is also a small toilet on the ground floor. On the first floor are 3 single rooms, and a small staff sleepin room that doubles as an office. On a mezzanine landing there is a bathroom and a separate small toilet. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over one morning, and a second visit took place one afternoon so that the Inspector could spend time with the 2 people who live here. Some time was also spent talking with the Manager about changes in the home, talking with staff about their jobs, looking at care records, and looking at some parts of the house. Sadly, since the last inspection one of the residents who had lived here for 16 years died unexpectedly. The staff and the 2 ladies who live here have dealt with the shock and bereavement very well over the past few months. There is now a vacant bedroom at the home. At the same time, one lady who has lived here for over 10 years, has now got her own flat and will be moving to this in the near future. This is a great success because that person and the staff have worked very hard together over the past year to make sure she is ready for semi-independent living. What the service does well: The home is very comfortable, nicely decorated, and a pleasant place for people to live. It is like any other house in this road, and the people who live here get on well with their neighbours and enjoy using local shops and being part of the local community. There is a friendly atmosphere in the house and the 2 people who live here enjoy the company of the staff who work with them. Staff were seen to be very polite and respectful to the 2 ladies who live here, and everyone joins in any chats about house and what to do each day. Staff are well trained and experienced so they know how to help people in the right way. There are plenty of chances for people to go out to their own chosen activities, and to social events to meet up with other friends. The home has done a very good job of helping one person to learn all the things she needs to move into her own flat, and that person and all the staff are very pleased about this. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 standard(s) 2, 4and 5. The needs of potential new residents are assessed to ensure that they could be met at this small home. Potential new residents have lots of opportunities to visit the house and meet other residents before they make a decision about moving here. Each resident has a written contract about the terms and conditions of their residence, and this is in a suitable format to support their communication skills. EVIDENCE: There is now a vacant place at the home. A Care Manager of the Social Services Department carries out an assessment of a potential new resident to see if they need long-term care. The Manager of the home then carries out an assessment of the person to see if this home can meet their individual needs. The assessments include the potential resident, their relatives, their Social Worker, and any other people involved in their care at this time. In this way, the home only admits people whose needs could be met here. The potential resident has also had lots of visits to the home to meet with the other people who live here. This gives the home staff a chance to assess their daily living skills and to see if they can physically get around the house. It also gives the potential resident and the people who live here a chance to meet and see if they could get along together. In this way the potential resident can try out the house and see if they like it. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 9 CIC provides each resident with a licence agreement that formally sets out the terms and conditions of peoples residence here and the level of fees. The Manager has also developed the licence agreement into easy language and pictorial print to support the communication and literacy skills of the people who live here. It includes their fees and contributions, and their signature. In this way residents have information about their placement. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6 and 9. Residents needs and personal goals are outlined in their individual support plan, and residents are fully included in these. Residents are supported to take acceptable risks as part of an independent lifestyle. EVIDENCE: There are support plans in place for both of the residents who live here. These are comprehensive, well organised and easy to follow. The files are divided into assessments of all aspects of peoples needs, including activities, daily living skills, personal hygiene, finances, and healthcare. There are long term plans for goals such as learning independent skills, and short term plans for goals such as booking holidays. Residents have monthly meetings with their keyworker to look at the progress of their goals and to discuss any new wishes and aspirations. In this way residents are fully involved in setting their own goals, and staff are able to plan out how they will support them to achieve those goals. Residents are supported to learn new skills and to take responsible risks where capabilities allow, as part of an independent lifestyle. One resident has spent B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 11 the past couple of years working, with staff input, towards independent living. She has gained independent skills, including cooking, going out on her own and staying in the house on her own. All of these activities have been recorded on risk assessments that show her capabilities, training and progress in skills. In this way the home has supported her to become as independent as possible and this has resulted in her being able to successfully move to a supported living flat. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 13 and 15. The people who live here are able to be part of the local community. Residents are supported to maintain contact with their relatives and also have a number of social events where they can meet up with friends outside the service. EVIDENCE: The house is indistinguishable from all the other terraced houses on this road. The people who live here make good use of all the local facilities such as shops, supermarkets, hairdressers, pubs and local transport. The 2 ladies have lived here for several years, and enjoy a good relationship with all their neighbours. In this way they are part of the local community. The people who live here use telephones to contact their friends and relatives and also invite them to visit the house from time to time. They also go out with relatives on occasions, and staff help residents to keep their relatives informed about any events or reviews that may involve them. The 2 ladies each have a wide circle of their own friends outside the service and they both enjoy different social events where they can meet up with other people. In this way they have opportunities to make new friends. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 standard(s) 19 and 20. The home ensures that residents health care needs are net by the appropriate healthcare services. One resident manages her own medication and there are clear systems for this and the management of other residents medication by staff. EVIDENCE: The 2 ladies who live here are supported to access their local GP practice and other community health care services, such as dentists and chiropodists. Staff also support one lady to access specialist health care services, including the eye infirmary and appliances clinic to meet her health care needs. In this way the ladies physical health care needs are met by the relevant health care services. Staff have supported one resident to learn how to manage her own medication, as she will need to continue this skill when she moves to her new flat. There is a clear risk assessment in place about this, and the residents bedrooms all have suitable lockable storage in which medication and other personal items can be securely stored. The other resident is not able to manage their medication at this time, so this is managed by staff. The home keeps a list of the staff who are designated as responsible for administering medication. At this time 3 of the 6 staff have had accredited B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 14 Safe Handling of Medication training. The others have not had this training yet, although they have had a brief training from the pharmacists about the Monitored Dosage cassette system. Records regarding the receipt and administration of medication were in good order and up to date. Staff are still making marks on the medication sheets to demote that an as and when required medication is not given. This is not necessary and could be confusing as some of the marks look like the number 1. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 standard(s) 22. Residents have clear information about how to make a complaint, and have opportunities to express any dissatisfaction. EVIDENCE: The home has clear information for residents about how to make a complaint. This is written in plain English and in pictorial format so that residents can understand it. The information is kept in a folder in the kitchen so that the people who live here can look at it at any time. In discussion both residents said that they would be comfortable about talking to the Manager if they had any concerns or were unhappy with the service at the home. The residents are encouraged to say what they think of the service at monthly House Meetings, on a daily basis with staff, and also at their monthly meetings with their keyworker. In this way the residents views are listened to. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 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 standard(s) 24, 26 and 30. The home is a pleasant, comfortable and safe environment for the people who live here. Residents bedrooms promote their independence. The house is clean and hygienic. EVIDENCE: There have been a number of planned improvements to this house over the past couple of years. This has benefited the people who live here and it now provides a comfortable, warm and well-decorated place for the 2 ladies to live. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 17 There is one vacancy at the home at this time, and in the near future there will be a second vacancy. There is a small run of steps up to the front door so the home would not be suitable for people with significant mobility needs. The house is owned by Three Rivers Housing Association, which remains responsible for any structural or major maintenance and repairs. There is also now a handyperson for the CIC homes in the North East region. This means the home can get help to fix minor repairs and decoration about once a month, and this will help to keep the home in good order. The 3 bedrooms are a good size and the people who live here make good use of their own rooms for privacy when they want some quiet time. All the bedroom doors have locks and one person uses her key to keep her bedroom private. All the bedrooms also have a lockable drawer so that residents can keep their personal possession secure. The home is very clean and hygienic. The 2 ladies are fully involved in all the daily household tasks, with the support of staff where necessary. The house has a utility room with a domestic washing machine that is suitable for this small home, and the people who live here. One resident is very involved in meal preparation and cooking, and staff have designed a number of easy ways for her to follow cooking instructions. Staff have also supported this person to understand good hygiene practices, including the use of different coloured chopping boards. At this time 2 staff have received training in Infection Control. The remaining staff have not yet received this statutory health & safety training. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 33. Residents are supported by competent, trained staff. The current level of staffing is sufficient only for the people who live here at this time. EVIDENCE: The staff team consists of the Registered Manager, 4 full-time and 1 part-time support staff (including one CIC bank staff). Three of the support staff have attained NVQ (care qualifications) levels 2 and 3, and the remaining 2 staff are starting training towards these qualifications. All the staff are mature and experienced. At this time there is no senior support post. In this way there is no one to take responsibility or to deputise in the absence of the Manager. At this time the home is allocated 163 support hours. This equates to 1.5 staff on duty through the day. This low level of staffing is only acceptable at this time as one of the two residents is now able to carry out most daily living tasks independently and is moving to semi-supported living in the near future. The other resident requires wheelchair support when out of the house and her needs within the house are increasing. If a new resident moves to the home the current low level of staffing will not be sufficient to provide support to 2 people, nor acceptable for health & safety within the home. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37 and 39. Residents benefit from a well run home. Residents views are sought and included in reviews of the service. EVIDENCE: The Manager has many years experience of working with people with learning disabilities. She has attained the Registered Managers Award and NVQ level 4 in Management. She has been the Manager for this home for 3.5 years. In that time she has been responsible for a number of improvements to the service and to the house. Discussions with staff and with residents indicated that this is a well managed home. The Manager is also responsible for the management of 4 supported living places in the nearby areas. Residents were seen to be fully included in discussions and decisions about their home. They have monthly care plan meetings with their keyworker where they talk about their goals and aspirations, and they have daily chats with support staff about their home. They are also asked for their views of the service at annual reviews of their placement, and asked by CIC to complete B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 20 satisfaction questionnaires. However the last questionnaires used by CIC were in quite small print and in quite complex language for the people who live here. In this way, residents needed the support of staff to complete the questionnaires, and this could have affected their responses. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x 3 x x x 2 Standard No 11 12 13 14 15 16 17 x x 4 x 3 x x Standard No 31 32 33 34 35 36 Score x 3 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 2 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x x x B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 22 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 30 33 Regulation 13(3) and 18(1)c(i) 18(1)a Requirement The remaining staff must receive training in Infection Control. For the admission of any new residents, staffing levels must meet a minimum of 2 support staff on duty thoruoghout the day. Timescale for action 1.12.05 On admission of new resident. 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. Refer to Standard 20 32 39 Good Practice Recommendations The remaining staff who are responsible for the administration of medication should receive training in Safe Handling of Medication. Consideration could be given to the post of a senior support staff who could deputise in the absence of the Manager. CIC should consider revising the format of Residents Questionannires in order to meet the comunication needs of the people who use this service. B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne Tyne Dock South Shields NE34 9PT 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 B52-B02 S15778 Mount Road V217657 090905 Stage 4.doc Version 1.40 Page 24 - 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!