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Inspection on 20/09/05 for Pia - 45 Old Hinckley Road

Also see our care home review for Pia - 45 Old Hinckley Road for more information

This inspection was carried out on 20th September 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 but made no statutory requirements on the home.

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

The home continues to provide a safe and secure environment for a small group of people with a variety of learning disabilities. Individual care diaries help staff record and give them a clear picture of how daily individual needs have been met. Service users were consulted and involved in their care and activities. In the absence of a permanent manager, the team leader was seen to be putting her knowledge and experience to good use.

What has improved since the last inspection?

Staff are working hard at supporting service users in activities. It was pleasing to see that activities were taking place on a more individual basis, rather than as a group. Improvements to the home, such as repainting, additional decoration and furnishings, have given it a more homely and relaxed feel. Food storage is much improved.

What the care home could do better:

More organised and planned activities could benefit residents, including annual holidays. `User friendly` communication diaries and life story books could help service users wishes be more readily expressed and understood by all. The appointment of a permanent manager is required, to ensure the long term satisfactory running and development of the home.

CARE HOME ADULTS 18-65 Pia - Old Hinckley Road, 45 45 Old Hinckley Road Nuneaton Warwickshire CV10 0AA Lead Inspector Martin Brown Unannounced Inspection 20th September 2005 10:20 Pia - Old Hinckley Road, 45 DS0000004277.V250038.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 Pia - Old Hinckley Road, 45 DS0000004277.V250038.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. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pia - Old Hinckley Road, 45 Address 45 Old Hinckley Road Nuneaton Warwickshire CV10 0AA 02476 382960 02476 640146 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) People in Action Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th April 2005 Brief Description of the Service: 45 Old Hinckley Road is a registered care home for six people with learning disabilities. The house is a converted detached building within walking distance of Nuneaton town centre. The majority of rooms and facilities are on the ground floor. There is a ground floor flat for one service user who has been assessed as benefitting from a degree of seperateness from the rest of the home, although he is encouraged to interact with the rest of the home at appropriate times. One service user has a bedroom upstairs, which is also where the staff sleeping-in room is located. There is a large garden area at the rear and car parking area at the side of the building. The garden has been made secure for the benefit of the single resident who lives on the ground floor flat. People In Action provide 24 hour care and personal support to the young adults living in the home. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place on September 20th at 10.20am and lasted for three hours. The inspector was made welcome by staff and service users, and saw and spoke with three service users, three staff and the acting manager. One service user was at a day service, one was not well, and a third is currently not at the home. 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. Pia - Old Hinckley Road, 45 DS0000004277.V250038.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 Pia - Old Hinckley Road, 45 DS0000004277.V250038.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): 1,2,5 Service users are supported by clear, simple contracts. Up to date service user guides would better assist any future prospective service users and their representatives. A full assessment by the home of any future admission or readmission will help minimise the risk of difficulties arising. EVIDENCE: There have been no new admissions since the last inspection. These standards were not fully assessed on this occasion, other than to note that the Service User’s guide still requires updating, and to note, more positively, that service user friendly contracts continue to be in place. Pia - Old Hinckley Road, 45 DS0000004277.V250038.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): 6,7,9,10 The individual care diaries are a good, convenient way of recording information in an accessible manner. As they contain private information, care should be taken that, while they remain conveniently accessible, they are stored appropriately, and not left out for any visitor to view. Staff consult service users regarding everyday activities and choices. Care needs are recorded in comprehensive files. Service users and staff may benefit from the creation of ‘life story’ books, communication diaries or similar; user friendly books written very simply and concisely in the first person, illustrated with plenty of personal photographs, showing personal likes and dislikes, strengths and needs, and things important to that person. EVIDENCE: Individual care diaries are kept in the communal area and filled in daily. These have pre-printed templates, allowing them to be filled in more easily, and making relevant information to be picked out more easily. The diaries were scattered on the work surface in the kitchen/dining room area at the outset of the inspection, although they were stored away later in a designated storage area. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 9 Staff were seen to be consulting service users about choices and activities, and striking a delicate balance between trying, for example, to persuade a resident to go out, because it was thought to be beneficial for him, and accepting his wish to stay in. The home continues to have comprehensive, detailed care plans, along with ‘user friendly’ formats, devised by the organisation, with plenty of pictures and symbols. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 10 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): 14,17 Service users are supported by staff in activities that are fairly ‘ad hoc’. The use of activity charts, whilst not needing to be rigidly adhered to, may help more activities to be planned. It was pleasing to see that activities were taking place on a more individual basis, rather than as a group. It is highly likely that residents would enjoy and benefit from an annual holiday. EVIDENCE: One service user enjoyed doing a jigsaw with staff. Another was happy to show me his impressive aquarium and fish. Staff organised a local trip out. Two service users were happy to go, a third did not wish to, and stayed at home. Originally planned as a walk, it was decided, at a service user’s request, to go in the car. The car, unfortunately, broke down, giving all a more eventful day out than anticipated. Holidays have not yet been organised for service users. Except for one healthy breakfast, meals were not observed on this inspection. Menus and available stocks indicated a good provision of healthy, fresh food. Food is stored appropriately. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 11 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 Service users receive personal and healthcare support in a manner that meets their needs and in ways with which they are comfortable. EVIDENCE: Individual records, discussion with and observation of staff with service users indicated that standards in respect of personal care and support continue to be met. The support of outside professionals is utilised; service users’ needs were met in a discreet and natural manner. Independence skills, particularly in regard to mobility, were encouraged. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 12 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): 23 Adherence to the organisation’s cross-gender policy will help minimise the risk of abuse. EVIDENCE: These standards were met on the previous inspection, and were not fully assessed on this occasion, other than to note the organisation’s cross-gender care policy. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 13 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): 24,25,26,28,29,30 The interior of the home now appears far more homely, thanks to a few minor improvements. The garden at the rear still requires urgent attention to turn it into a positive amenity. This attention should also ensure that surplus items, such as mattresses and disused fish tanks do not remain there any longer than is strictly necessary. EVIDENCE: The main lounge had been repainted, and, with the addition of some flowers and ornaments, is now much more ‘homely’ than at the previous inspection. Those bedrooms seen were personalised with pictures, ornaments, and preferred colours, and were being redecorated in turn. The home was clean and hygienic throughout. There is a small patio area to the side of the house with flowers and herbs in pots, making good use of the space there. The larger garden area at the rear is still inaccessible because it is overgrown. The manager advised that work on this was to be agreed within the week. Rubbish had been removed from the garden area since the last inspection, but there were further items there. Pia - Old Hinckley Road, 45 DS0000004277.V250038.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): 32,34,35,36 Staffing was sufficient to meet the needs of current service users. The anticipated return of one service user to the home will require additional staffing. Clarification of satisfactory Criminal Records Bureau checks is needed to show that recruitment processes are satisfactory. Clarification, or reminders, to the staff team regarding the organisation’s cross gender care policy will help ensure this continues to be carried out appropriately. Annual appraisals will help identify training and other needs, as well as strengths and paths for further development. EVIDENCE: Three staff, plus the acting manager, were available to meet the needs of individual service users. One service user is currently in a long-stay hospital. Staff were observed to be interacting with residents in a caring, competent and professional manner. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 15 The staff group is predominantly female. There is an organisational policy regarding cross gender staffing and personal care, stating that personal care of females by males should be avoided. There was some uncertainty regarding this, although current staffing ratios and rotas enabled appropriate care. The rota was able to ensure that female staff were always available. Staff appraisals are not currently taking place. A staff register was seen detailing individual Criminal Record Bureau check numbers. This indicated that they had taken place, but, in the absence of the individual certificates, there was no dated signature by a manager or other responsible person to confirm that these had been seen and were satisfactory. Staff training is ongoing in mandatory and specialist areas, such as dementia, with staff being booked for such training where deficits have been identified. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 16 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): 37,38,39,42 The home is currently running well on a day-to-day basis, but needs a permanent manager to ensure the long-term maintenance and development of the service. EVIDENCE: The home does not currently have a manager. The acting manager, Angela Rynn, who currently shares this duty with running another home, advised that the organisation is shortly to re-interview for the post. Although the home appeared to be running well on a day-to-day basis, with service users receiving individual attention, having choices and preferences heeded, and having a variety of activities, the absence of a permanent manager showed in areas such as the lack of a current development plan for the home, the lack of development of Quality Assurance processes, of updated Service User Guides, and the lack of planned activities, including holidays. Satisfactory fire safety procedures and records were seen to be in place. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 17 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 3 2 X X 3 Standard No 22 23 Score X 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 3 Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 X 2 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 2 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 2 2 3 2 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pia - Old Hinckley Road, 45 Score 3 3 X x Standard No 37 38 39 40 41 42 43 Score 3 2 2 x x 3 x DS0000004277.V250038.R01.S.doc Version 5.0 Page 18 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 2 Regulation 5 Requirement The Service User Guide is to be updated. (This is an outstanding requirement from the previous inspection.) Service users must be offered annual holidays. The organisation’s cross-gender care policy, and its application to 45 Old Hinckley Road, must be clarified with the staff team. The garden must be made accessible, in line with the Statement of Purpose for the home, and surplus items disposed of within reasonable timescales. (This is an outstanding requirement from the previous inspection.) The home must recruit a permanent manager. A permanent manager must be available to instigate quality assurance procedures, staff appraisals, and develop the home’s annual development plan. Signed and dated confirmation of satisfactory Criminal Records Bureau checks must be available in the home. Timescale for action 27/12/05 2 3 14 23,33 16(2) 12,13(6) 27/10/05 27/10/05 4 28 23 27/10/05 5 6 38 39,36 8 10 27/11/05 27/11/05 7 34 19 27/10/05 Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 19 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 6 6 12 Good Practice Recommendations The creation of ‘user friendly’ life story books/ communication diaries could help service users and staff in expressing and meeting needs and wishes. Daily care diaries should be stored discretely when not in use. The use of activity charts would help in forward planning activities for service users. Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 20 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 Pia - Old Hinckley Road, 45 DS0000004277.V250038.R01.S.doc Version 5.0 Page 21 - 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. 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