Inspection on 09/02/06 for Occupation Road

This inspection was carried out on 9th February 2006.

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

The inspector 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

Occupation Road 26/02/07

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 Occupation Road Occupation Road Corby Northants NN17 1AG Lead Inspector Mrs Mary Timms Unannounced Inspection 9th February 2006 9.30 Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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 Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Occupation Road Address Occupation Road Corby Northants NN17 1AG 01536 403924 01536 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) londonroad@tiscali.co.uk Milbury Care Services Limited Mrs Phyllis Duff Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. The age range of service users accommodated in the four person flat shall be between the ages 19 to 45 years The age range of service users accommodated in either of the two person flats shall be 45 to 65 years Only service users with a learning disability may be admitted to the home Any person admitted into the home with a physical disability (PD) must also have a primary care need of learning disability (LD) The number of service users must not exceed eight (8) in number To be able to admit the named person of category LD named in variation application number V26629 dated 09.11.05. Date of last inspection Brief Description of the Service: The home is situated amongst residential properties in the suburbs of Corby town. The premises are purpose-built, designed to provide residential placements for eight people with a learning disability, the majority of whom also have physical disabilities. There is a very large rear garden and car parking to the front. A mini-bus is provided to support residents to access a range of local community resources. Accommodation is provided across three spacious areas; upstairs two female residents live together in one apartment and two males in the second apartment. Whilst these apartments provide more independent space residents also mix for some mealtime and social occasions. Downstairs are four bedrooms for more dependant residents. One staff team works across the home providing support to all eight residents. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection made during the morning and lasting approximately four and a half hours. This is the first inspection visit to this home, which opened in August 2005. Three residents were case-tracked which involved talking to them, reviewing their records, looking at the accommodation specifically used by them and talking to a keyworker to one individual. During the visit the inspector spoke with the Deputy Manager, three members of care staff and three residents. Due to the level of disabilities feedback from residents to inform this report is limited. What the service does well: What has improved since the last inspection? What they could do better: Written care plans are needed from the beginning of a placement, rather than some months later, these should set out the detail of the care to be provided including guidance for staff. Whilst there is no concern they are being used inappropriately the use of cot sides should be supported by the signed agreement of the community nurse. Where carers are providing tasks, which border on being a nursing role, consent is needed from a health professional delegating their responsibility for the task to the care staff. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 6 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. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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 Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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): 2 Good processes are in place to ensure residents are appropriately placed within this home. EVIDENCE: Each of the three files viewed for case-tracking purposes, held both Care Management Assessments and detailed pre-admission assessments undertaken by the home, prior to a placement being offered. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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 Residents are well consulted and involved, where possible, in the arrangements for their care. EVIDENCE: One of the files viewed held well-developed and detailed plans across a range of documents, i.e. A Personal Pen Picture, which reflects the individual preferences of the service user regarding their personal care, likes and dislikes around daily living and personal interests. A Health Care Plan, which has been developed in an appropriate format to aid residents understanding, including symbols, signed by residents and/or family members. Further Care Plans and risk assessments also informed the delivery of Care. The plans in this one file would clearly meet the expected standard; unfortunately the other two files viewed lacked any detailed planning documents. The deputy manager clarified that plans are currently being developed for all residents; some individuals have though been in residence for several months. From observations made during this visit and discussions with several members of staff, it is evident that promoting opportunities for residents to make decisions and personal choices is a priority. Residents are always Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 10 encouraged to choose the clothes they wear each day, are involved in menu planning and make choices around activities. One member of staff described how, within her role as key worker, she is developing communication methods with a particular resident to support her ability to make personal decisions and choices. On the day of this inspection visit an advocate was visiting one particular resident identified as needing support around a specific issue. Detailed risk assessment documents have been developed around general living with within the home, in relation to specific residents and specific activities. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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): 12,13,14,15,16,17 A supportive staff team encourage residents to access a range of activities and new experiences. EVIDENCE: Although there are restrictions due to the level of disabilities for some residents, where appropriate they attend a range of day-centre services identified to suit their individual needs. Staff confirmed that there is good communication between the home and day-centre services. Residents are also supported to access a range of community resources. On the day of this visit two residents went out with two members of staff to purchase supplies from the local Asda store and to a “outlet store” for some shelving for a residents bedroom. One resident described how she had been taken to see Cliff Richard the previous week (Tribute act). It was established through a review of records and through discussion with staff and residents that individual and group activities are well supported. Residents go out for a range of shopping needs; one resident noted as being taken to the local pub Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 12 for a drink, another out for tea, for a walk to the park to feed the ducks, also trips to the cinema and theatre. Residents confirmed they receive family visits in the home. A book of “complaints and compliments” kept by the door of the home held several compliments (and no complaints) from families expressing their positive view of the service and how welcome they felt when visiting the home. Several residents have had birthday parties arranged which families have attended. On the day of this visit residents were seen to choose to spend time in their bedrooms, within their more independent apartments, or to mix together over meals. Observations were made of staff interacting with residents whilst monitoring their well-being. Menus are planned with residents on a weekly basis, menus viewed showed a balanced diet on the week of this visit. Some meals are supported in the more independent areas of the apartments and others in a larger group downstairs. All dining areas were noted to be laid out in a domestic style with pleasant furniture and décor. Staff were observed being extremely caring and supportive over a mealtime during this inspection visit. It was identified that guidance from a health professional regarding the need for a specific resident to have 18g of fibre daily has not been reproduced into a written plan to guide his diet. Staff were unable to evidence how this need is met, but felt confident that his needs are taken into consideration within menu planning. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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 Health needs and personal care support are well provided for in this home. EVIDENCE: The inspector spoke with three residents all of who confirmed that they feel well supported by staff. One resident stated, “The best thing here is the staff”. Of the plans viewed there is an emphasis on residents likes, dislikes and preferences in relation to the provision of personal, care and support. Staff confirmed that residents are encouraged to always choose their own clothes. From discussion with staff and evidence gathered from records it is apparent that a range of external support is accessed to meet individual needs. On the day of this visit two staff from the psychology team were visiting one resident. Podiatrist, speech therapists, breast screening unit, community nursing, and dieticians are amongst the range of health professionals currently supporting residents at this home. The inspector spoke with the visitors from the psychology team who made positive comments around this service, stating that good records are kept and residents are well supported during their visits. On the day prior to the visit, a resident had been noted by staff as particularly unwell, it was apparent from records and discussions with staff that appropriate actions had been taken and that the resident was well supported and monitored. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 14 Several residents have specific needs, which require nursing support. Community nurses and dieticians have provided training to staff to enable them to support some areas of care, staff spoken to seemed knowledgeable and confident around these areas of care. Whilst one need was endorsed by signed delegation, from the appropriate health professional, for the task to be undertaken by named staff who have been trained appropriately by that health professional, this practice was not followed through in other areas of care i.e. a medication given by suppository, peg feeding, daily care of tracheostomy. Medication is stored appropriately and records are kept of any medication administered to residents. Staff attend training in relation to the administration of medication. Two minor shortfalls were identified; stock control records showed that 100 Co-codamol were in stock when actually there were 172, an envelope was also noted in the cabinet containing paracetamol tablets, which had been brought in by a relative but had not been entered in the medication records. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Staff are knowledgeable around issues of protection, however senior staff should really be more aware of the appropriate locally agreed reporting procedures should the need arise. EVIDENCE: The organisation has a complaints procedure; a précis is set out with the Service User Guide. The Deputy Manager clarified that no complaints have to date been received about the service. Currently any low-key concern raised by families would be recorded on individual records, rather than in a central log, which would support good management oversight of such issues. One resident spoken to during this visit was able to confirm that she felt confident to raise a complaint and that staff would respond to her concerns. Records show that staff have attended training in relation to the Protection of Vulnerable Adults. On the day of this visit staff were unaware of the locally agreed procedures for reporting any abuse or suspicion of abuse, but were confident that any issue would be reported to external managers to respond to. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,29 and 30 Residents live in a supportive and pleasant environment well designed to meet their identified needs. EVIDENCE: The premises were purpose built in 2005 to provide appropriate facilities for up to eight residents with disabilities as set out within the Statement of Purpose. The building has been well designed to meet the needs of residents and was found to be decorated and furnished to a high standard. The home provides excellent environmental amenities for residents with a physical disability including the apartments where kitchen facilities are provided for wheelchair users. On the day of this visit all areas were found clean and well maintained. A good-sized laundry area is available, fitted with appropriate machines and away for living areas of the home. Records show that staff have been trained regarding infection control. The use of cot sides is not currently supported by evidence of agreement by community nurses and families. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34, and 35 Residents are supported by a caring and committed staff team who are well trained to provide the level of care needed in this home. EVIDENCE: The staff team has some very experienced members of staff supporting less experienced staff who are developing their knowledge and skills. Robust recruitment procedures are operated and the Deputy Manager confirmed that no new members of staff commence work in the home, until an appropriate check has been undertaken with the Criminal Records Bureau. New staff undertake a structured induction to the home followed by a foundation level course, which is Learning Disability Award accredited (LADAF). NVQ 2 training is also provided, however, at this current time less than the recommended 50 of staff have completed this award resulting in one area of national minimum standards found as unmet. A range of other identified core training is provided to staff including, fire safety, moving and handling, food hygiene and the protection of vulnerable adults. Staff confirmed they feel they are provided with adequate training to enable them to undertake their role. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 18 Where it was identified that odd members of staff have not attended some training, senior staff confirmed they would not be allowed to undertake some tasks, for example: moving and handling, preparing food without attending the food hygiene course. The staff team on duty on the day of this visit were clearly very passionate about their role; keen to provide the best possible level of care. Observations made on the day demonstrate that staff are caring, supportive and provide a cheerful atmosphere for residents. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 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 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, and 42 Evidence gathered throughout this visit confirms there is good management of the services provided. EVIDENCE: The Registered Manager was approved for this position when the home opened in August 2005 and was found to be appropriately experienced and qualified at that time. A deputy manager supports the Registered Manager’s role. Records show that appropriate checks are undertaken in relation to fire safety with system checks being completed on a weekly basis and with regular fire evacuation drills. Health and Safety training is provided to staff in relation to general health and safety, food hygiene, fire safety, infection control, emergency first aid and moving and handling. Disability equipment is well maintained. On the day of this visit all the beds were being serviced by the suppler. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 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 3 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 X 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 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X X X X 3 X Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 21 na 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. 1 2 3 4 5 Refer to Standard YA6 YA7YA6 YA17 YA20 YA35Y A19 Good Practice Recommendations Care Plans should be developed by the home at the beginning of a placement setting out all areas of care provision. Care Plans should set out clearly the arrangements for resident’s personal finances with guidelines for staff in relation to the level of support necessary, Guidance from health professionals should always be incorporated into a care plan to ensure identified needs are met. All medications brought into the home should be entered into the recording system (medications) operated in the home. All areas of care, which cross into areas normally provided by a health professional, should be supported by signed delegated responsibility from the appropriate health professional for named staff, who have attended required training, to take on some tasks to enable needs to be met. Occupation Road DS0000064167.V280512.R01.S.doc Version 5.1 Page 22 6 YA22 7 8 YA23 YA29 Any issue of concern raised by residents or families should recorded in a central log to evidence actions taken in response to such issues and enable managers to have a clear oversight and monitor for any trends. Staff should be made aware of the locally agreed reporting procedures for any issue of or suspicion of abuse The use of cot sides should be supported by the written agreement of the community nurse and family members. 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