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Inspection on 21/09/05 for Paks Trust Clarence Street

Also see our care home review for Paks Trust Clarence Street for more information

This inspection was carried out on 21st 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 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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

Each of the three houses provides a small, comfortable, domestic environment for either one or two residents. Individual person centred care and support is provided to the residents that live in the houses. The staff teams are dedicated to each house thus they know the needs of the residents very well. Community activities are arranged and supported as the residents require, as are day service placements and holidays. Recruitment practices are in keeping with good practice guidelines, and ensure that the residents are protected.

What has improved since the last inspection?

Staff within the houses have been made aware of the Code of Conduct laid down by the General Social Care Council. Records of weekly fire tests are maintained.

What the care home could do better:

Residents care plans are of very differing standards across the three houses This requires addressing to ensure that a consistent approach for all of the residents is achieved. The staff team appear committed and dedicated to their work however, they are not supported through regular formal supervision sessions in line with national minimum standards.

CARE HOME ADULTS 18-65 Paks Trust - Clarence Street (17/18 & 42) 17 Clarence Street Nuneaton Warwickshire CV11 5PT Lead Inspector Justine Poulton Announced Inspection 21st September 2005 08:30 Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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 Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Paks Trust - Clarence Street (17/18 & 42) Address 17 Clarence Street Nuneaton Warwickshire CV11 5PT 02476 742201 02476 742201 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) PAKS Trust Mr Robert S Forsyth Care Home 5 Category(ies) of Learning disability (5) registration, with number of places Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Mr Forsyth achieves the NVQ Level 4 in managing care, including the Registered Managers Award by 1 February 2006. PAKS Trust must provide adequate support to the registered manager, which takes into account his level of management experience and experience of working in residential care. For the first 12 months from the date of this (the registration) certificate this support will include regular (at least quarterly) meetings with a care home manager who has current experience of providing an operational presence in a care home, who will act as the registered manager`s mentor. This mentoring process will be in addition to supervision and support from the registered manager`s line manager. 1st March 2005 Date of last inspection Brief Description of the Service: The registration of Clarence Street covers three separate houses in one street. Two of the houses are for two residents and the other is for one resident. These are terraced houses, each providing a domestic environment as a care home setting. Two of the houses have a communal living room, kitchen and bathroom on the ground floor. The third has the bathroom on the first floor. Service users’ bedroom(s) are also the first floor. All of the houses are staffed 24 hours a day and personal care is offered to some degree in all three houses. The registration is for residents with learning disabilities. PAKS Trust operates this service. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday and was carried out from 8:30am until 13:40pm. The manager, residents and staff co-operated fully with the inspection. A total of 14 standards were inspected on this occasion of which 2 had shortfalls. One of the residents was at home for part of the day and was spoken with informally. Five staff members were also spoken with. In addition to this, records, files and policies and procedures were also inspected. The inspector would like to thank the manager, residents and staff for their cooperation and hospitality during the 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. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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 Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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): x EVIDENCE: No new residents have been admitted to the home since the last inspection, therefore standards one to four are deemed to be not applicable on this occasion. Standard five was not inspected. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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): 6. There is not a clear, consistent care planning system in place across all three houses to adequately provide staff with the information they need to satisfactorily meet residents needs. EVIDENCE: Care plan documentation was examined in two out of the three houses, and was found to be of very different standards. Work has recently been undertaken by the registered manager to update and improve the format of the care planning documentation in house number 17. The information within this has been taken from knowledge of the resident, the resident herself and documentation from a recent Social Services review. Care plans looked at in house number 18 were in place, but were untidy and scrappy, with information being difficult to find at a glance. The manager stated that the format of the plan developed for house number 17 was to be adopted across all three houses. Staff on duty in two of the houses said that the service is very much resident led. This was observed to be the case in house number 17 in conversations between the resident and staff on duty. No staff or residents were available in house number 42 in the later part of the morning. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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): 12 and 15 Residents have the opportunity to live ordinary and meaningful lives appropriate to their needs. They are supported and enabled to be part of the local and wider community. EVIDENCE: Information regarding daytime activities was available within one care plan examined. The organisation offers a day service provision, which this resident attends for two days each week. The other three days are spent at a day service provision in a neighbouring town. Activities such as cooking, craftwork and attendance at a local gym are participated in at these day services. It was advised by the resident and staff that during the evening and at weekends shopping, going to the local club and going to see concerts and shows are enjoyed, as well as holidays. In one other care plan looked at however little information regarding their day time activities was available. Information was available to confirm that the residents have contact with their families to a greater or lesser degree through visits and telephone calls as they choose. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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): 18 and 20 Resident’s health-care needs are identified on their care plan and are met with appropriate specialist support. Medication is managed safely. EVIDENCE: Although care plan documentation looked at was of very different standard across two of the houses, information regarding resident’s personal care and support needs was available within the files looked at. In one file this included specific routines that are followed by the resident. Staff spoken with were knowledgeable about the care needs of the residents and were able to talk about specific needs where highly individualised care and support is required. Information regarding medication was available within one residents file looked at. This included information on each medication along with details of common side effects. The same level of information was also available regarding any homely remedies that may be taken. Medication is currently supplied to the home by a company based in Leicester via local chemists. It is supplied in blister packs, which are accompanied by medication administration record sheets. The medication and record sheets looked at provided no cause for concern on the day of the inspection. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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): x EVIDENCE: No standards in this section were inspected on this occasion. They will be looked at, at the next inspection of this home, later in the 2005/06 inspection year. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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, 28 and 30 Each of the three houses is appropriate for resident’s particular lifestyles and needs. All are accessible to community facilities and services. EVIDENCE: The three houses covered by the registration that make up the Clarence Street service are two mid-terrace houses and one end terrace. Each provides a domestic environment as a care home setting. Two of the houses have a communal living room, kitchen and bathroom on the ground floor. The third has the bathroom on the first floor. Residents’ bedrooms are also the first floor. All three houses were comfortable, nicely furnished, clean, tidy and homely. Number 17 has recently been decorated throughout the ground floor, and the resident said that her bedroom is to be decorated very soon. The staff on duty advised that new carpets are needed throughout the house, and new sofas in the lounge would be of benefit. There was plenty of personalisation throughout the house in the form of photos, ornaments and plants. Houses 18 and 42 were also nicely decorated and well furnished, however one resident had a broken wardrobe in his room. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 13 There was also a plastic sliding door to a store cupboard in a bedroom, which detracted from the overall bedroom environment. House number 42 also had a sliding door in place in the hallway, again which detracted from the overall appearance of the environment. Each house has a lounge and dining area available for residents to share if they wish. On the day of the inspection all three houses were clean and tidy, with no unpleasant odours apparent. The houses are small and domestic in scale with cleaning procedures in place that reflect this. Staff spoken with advised they have to use cleaning products that are purchased from a large company on a bulk buy basis, and would much prefer to be able to buy products from local supermarkets with the residents when on the weekly shopping trip. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 14 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, 33, 34, 35 and 36 A committed, motivated staff team supports residents. Staff have been recruited to work in the home in line with current good practice that safeguards residents. The lack of staff supervision leaves residents vulnerable to potential risk to their health and well-being. EVIDENCE: Each house has its own dedicated staff team that is lead by a house supervisor. The registered manager then oversees all three houses within the registration that makes up the Clarence Street service. The registered manager does not have a permanent base in any of the houses, however the main office base is within reasonable distance of the houses. Staff spoken with were knowledgeable about the residents that they support, and interactions observed were positive and resident focused. Staff records examined confirmed that the organisations recruitment procedures are safe, with copies of the relevant documentation in place. There was little evidence to confirm that staff are supervised in line with minimum standards however. Training records looked at confirmed that staff have received training in the mandatory areas within the last three years . Training has also been undertaken in more specialist areas such as autism, healthy eating, epilepsy and infection control. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 15 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): 42 Safe working practices in the houses ensure that resident’s health, safety and welfare is being promoted and protected. EVIDENCE: The health and safety of both residents and staff is maintained as far as is practicable within each of the three houses. Records to confirm that the necessary health and safety checks are carried out in accordance with legislation were in place. Fire alarms are tested on a weekly basis and a fire drill is held every eight weeks. Both the Landlords Gas Safety Record and records of Portable Appliance Testing were current. Control of Substances Hazardous to Health data sheets were in place. A contract with Cannon Hygiene is in place for the removal of clinical waste. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.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 x x x x x Standard No 22 23 Score x x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 x x x x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x 3 x 3 LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 2 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 17 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 YA6 Regulation 15 Requirement The standard of residents care plans across the houses requires addressing to ensure that a consistent approach for all of the residents is achieved. Staff must be provided with formal, recorded supervision a minimum of six times per year. Timescale for action 31/12/05 2 YA36 18(2) 31/12/05 Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 18 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 Refer to Standard YA24 Good Practice Recommendations It is recommended that all plastic sliding doors be replaced. Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 Paks Trust - Clarence Street (17/18 & 42) DS0000004458.V255113.R01.S.doc Version 5.0 Page 20 - 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. 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