Please wait

Please note that the information on this website is now out of date. It is planned that we will update and relaunch, but for now is of historical interest only and we suggest you visit cqc.org.uk

Inspection on 12/05/05 for Pia - 136 abc Manor Court Road

Also see our care home review for Pia - 136 abc Manor Court Road for more information

This inspection was carried out on 12th May 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

Managers and staff are supporting service users to live fulfilling life outside as well as within the home. Service users spoken with were enjoying a wide variety of leisure activities and being involved in the day-to-day running of home activities. Opportunities for meaningful occupation and appropriate education and training for service users appropriate to their needs have been accessed well. This includes local authority day services, college courses and work placement. At each visit to the home service users were either going to these activities or returning from them. Service users coming home from activities were happy to tell the inspector about their day which they had obviously enjoyed.

What has improved since the last inspection?

There have been significant changes to the environment since the last inspection and service users spoken with were very positive about the changes this had made for them. This included, "it`s better having a kitchen downstairs", "I really like it" and " it`s all nice". Staff spoken with felt the accommodation now provided more opportunity for the social development of service users and still provided opportunity for service users to be alone if they wished.

What the care home could do better:

The care plan review procedure must improve to ensure that care plans reflect the changing needs of service users and that staff have up-to-date information and guidelines necessary to maintain the health and well-being of the people they care for. Staff skills and knowledge must be developed to ensure that the health and well being of people as they grow older and continue to live in the home can be met safely and appropriately. Systems for medicine management must be more robust to ensure the service users receive the medicines as prescribed. Procedures in place for notifying the Commission of events that affect the health and well being of service users must be actioned in all instances. The storage facilities for equipment in the home must be improved to ensure it does not infringe on the privacy of service user`s bedrooms.

CARE HOME ADULTS 18-65 PIA - 136abc Manor Court Road 136a Manor Court Road Nuneaton Warwickshire CV11 5HQ Lead Inspector Sheila Briddick Unannounced 12 May 2005 09:00 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. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service PIA - 136abc Manor Court Road Address 136a Manor Court Road Nuneaton Warwickshire CV11 5HQ 02476 643776 02476 640146 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) People in Action Mrs Julie Ann Morrissey PC 4 Category(ies) of LD 4 registration, with number of places PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 08 September 2004 Brief Description of the Service: 136 Manor Court Road is a registered care home for four people with learning disabilities. People in Action provides 24 hour care and support for the people living in the home. The home situated on one of the main routes into the town of Nuneaton, which is easily accessed by the people living in the home. The groundfloor accommodation consists of a kitchen and lounge, two service user bedrooms, each having an ensuite facility. On the first floor of the property there are two service user bedrooms, a lounge, bathroom with toilet and an office/sleeping room for staff. There is a large garden at the rear of the property, which provides lawned and patio areas. There is parking space for one car in the driveway to the house. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place over five hours and was unannounced. A tour of the premises took place and staffing and care records were examined. There are currently three service users living in the home and their views were sought during the inspection visit and included in this report. Two staff on duty at the time of the inspection and the registered manager for the home were spoken with. Since the last inspection there have been changes made to the environment. The environment previously consisted of two separate living units, each accommodating two service users. Accommodation is now provided as one single living unit. The registered provider sought advice from the Commission for Social Care Inspection when planning the environmental changes and appropriate consultation took place with the service users. What the service does well: What has improved since the last inspection? There have been significant changes to the environment since the last inspection and service users spoken with were very positive about the changes this had made for them. This included, its better having a kitchen PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 6 downstairs, I really like it and its all nice. Staff spoken with felt the accommodation now provided more opportunity for the social development of service users and still provided opportunity for service users to be alone if they wished. 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 - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 There have been no new service users coming to live in the home for some time. There is currently a vacancy in the home. This standard will be fully assessed at the next inspection if the vacancy has been filled. EVIDENCE: PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 standard(s) 6, 7 and 9 Service users are not having opportunity to review their care plan. Without this discussion service users cannot be sure that they are receiving the appropriate support to meet their needs and staff are not able to demonstrate that service users are making individual choices and decisions regarding their lifestyle, health and well-being. Care plans are not being reviewed and maintained up to date to reflect changing needs. EVIDENCE: Two care plans were examined at this visit. In both instances dates of the last review taking place were recorded. The content of the reviews however, including who attended, the agenda for the review and the views of the service user were not recorded on the care plan. Without this information staff are not able to demonstrate the ongoing development of individual service users in meeting their personal goals or that the service is addressing changing needs appropriately. Individual health notes kept on care plans indicated recent changing needs for service users involving their mobility, change of medication, personal care and dietary needs. Care plans or risk assessments had not been amended to reflect these changing needs. This included risk assessments for eating and swallowing difficulties, mobility around the home and challenging behaviour. Unless care plans are amended staff will not have sufficient information they need to meet individual service user needs PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 10 appropriately or safely. This includes ensuring that staff have written protocols and guidelines to follow which have been agreed with specialist services, including psychologists. Staff working in the home were supporting service users to make decisions about everyday activities. This included choices regarding the evening meal, leisure activities and some decision-making regarding future holidays. A service user talked to the inspector about choosing the colour of the wallpaper for their bedroom, which was being decorated. Two service users share the use of a car. There was an agreement for this on each of the service users care plan and family member support had been made available to the service users when drawing up of the agreement. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 standard(s) 13, 16 and 17 People living in this home have opportunity to live ordinary and meaningful lives appropriate to their needs. They are supported and enabled to be part of the local community in which they live. Lifestyle in the home promotes and respects service user rights and responsibilities. EVIDENCE: A service user spoken with said that they liked living in the home. They said that they had opportunity to go shopping for food if they wished. Other comments included, its all nice here, it is much quieter here and I like that. Service users and staff spoken with were happy with the recent changes that have been made to the environment. Staff felt that the lifestyle of service users had greatly improved especially regarding opportunity for social skill development. Staff felt that service users were much happier living together as a group rather than living in single units. Service users were particularly happy about having a kitchen facility downstairs. Service users are using the local health-care facilities of GP Surgeries, Dentists and Opticians. Service users said that the GP surgery was nice and that they liked their doctor. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 12 Personal diaries record a wide variety of activities are enjoyed locally and further a field. Recent holidays were discussed. Service users had enjoyed trips to Torquay, London and Skegness and were planning a trip to Blackpool. One service user particularly enjoys trips to the cinema. Another service user is happy that they are able to attend their church each Sunday. Staff spoken with demonstrated a commitment to providing and supporting individual lifestyle activities for service users. Service users said that they liked the food they had and were able to have their favourite foods. This was reflected on individual menu records that are being maintained. The dietary needs of service users are assessed by the dietician services and speech and therapy services. Staff spoken with are able to access training in food hygiene. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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) 20 Staff spoken with had a good understanding of the medication policy for the home and the medication needs of service users. The home was eager to improve their current system for medicine management. Enhanced robust systems had not been installed to check all the medication received into the home, which had led to some discrepancies in the records of administration. EVIDENCE: Examination of medication records demonstrated that medicines were administered as prescribed. However balances of medicines from previous cycles had not been carried over onto the current Medicine Administration Record, (MAR) chart. When required medication did not have sufficient written protocols for staff to refer for their administration. Two instances of medicine not being administered had been recorded on care notes but not on the MAR chart. The tablets had been removed from the dosage system packaging and placed in an unmarked envelope in the medication cupboard. Changes to medication had been recorded on health care notes however the care plan record had not been amended to reflect the change. Service users are giving their consent to medication when able and this has been recorded on their care plan. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 14 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 and 23 There are policies and procedures in place to ensure that service users are protected from harm. The procedure for notifying the Commission for Social Care Inspection of the occurrence of events that affect the health and wellbeing of service users is not always actioned. Effective systems are in place for listening and responding to issues raised by service users, family members or advocates. EVIDENCE: A record of all concerns and complaints is being maintained. The record demonstrates that all complaints are investigated and that service users can have advocacy support during the investigation if they wish. Staff access training in the Protection of Vulnerable Adults (POVA) as part of the Principles of Good Practice training. The complaints policy and information for service users regarding the Protection of Vulnerable Adults is easily accessible to them and in a written and symbol format. Service users were asked if they felt safe in the home and whom they would talk to if they were worried about something. Service users said that they felt safe, that the staff treated them well and listened to them. Service users also said that they had somewhere to keep their belongings private and can have a key to their room if they wish. Service users spoken with did not wish to have a key. The record is maintained of all the incidents/accidents that affect the health and well-being of service users. The Commission had not been informed of all incidents recorded and this included medication not being administered to service users, incidents of harm to staff by service users and unaccountable bruising to service users. This information must be forwarded to the PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 15 Commission who will monitor that action has been taken to minimise risk and maintain the health and well-being of service users. Discussion with the registered manager and examination of records evidenced that appropriate action had taken place following the incidents. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 and 29 The appearance of this home has significantly improved since the last inspection creating a comfortable and safe environment for those living there and visiting. EVIDENCE: Since the last inspection a single living environment has been re-established. Previously the environment provided living accommodation in two flats each for two service users. The home is now more suitable for its stated purpose, accessible, safe and well maintained. Service user’s individual and collective needs can now be met in a comfortable and homely way. Service users spoken with were delighted with the change. The environment still allows for individual service users to be alone if they wish in an area other than their bedroom. The redecoration programme is almost complete. A bedroom was being decorated at the time of the inspection. The service user talked about choosing the bedroom wallpaper with staff and the new furniture she had. There was some equipment being stored in this bedroom, which did not belong to the service user. Storing of ‘ home’ equipment in the service users bedroom imposes on their privacy and the equipment must be removed. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 17 Service users have the specialist equipment they require to maximise their independence and this includes provision of, moving equipment, bathroom fittings, wheelchairs and call alarm systems. The equipment is provided following assessment by Occupational Therapists and risk assessment. Staff were observed to support service users with moving equipment in a sensitive and safe manner. The inspector was informed that further training in the use of the equipment is planned. This training will ensure that all staff have been assessed as competent for the safe use of the equipment. The premises were clean, hygienic and fresh at the time of the inspection. Staff are receiving training in infection control and there are systems in place to control the spread of infection in the home. This includes provision of protective clothing for staff. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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) 33 and 35 The home has an effective staff team who listen to service users, understand their needs and have opportunity to develop and maintain skills. The knowledge and understanding staff have is not sufficient to meet the needs of people, as they grow older. EVIDENCE: Staff on duty at the time of the inspection were observed to be accessible and approachable to service users, good listeners and communicators. Staff spoken with felt they had the competencies to carry out the tasks required of them and were able to access training appropriate to the service needs. This included training in challenging behaviour, administration of medication, communication and moving and handling. Staff are waiting for training in the new hoisting equipment that has recently been acquired to be used with a service user. Staff spoken with were aware that their skills, knowledge and understanding of meeting the needs of people as they grow older will require further development if they are to continue to be able to meet the needs of service users in this home. There were sufficient to staff on duty to meet the needs of service users at the time of the inspection. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 19 Team meetings are held on a regular basis and minutes maintained. All areas of the service provision and service user needs are discussed at team meetings. Staff spoken with confirmed they had regular supervision and opportunity to discuss their training needs. PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 20 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) These standards were not assessed on this occasion. Standards 37, 39, 42 and 43 were assessed and met at the last inspection. EVIDENCE: PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 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 N/A x x x Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x 2 x Standard No 11 12 13 14 15 16 17 x x 3 x x 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 PIA - 136abc Manor Court Road Score x x 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 22 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 6 Regulation 15 Requirement Care plans must be reviewed with the service user as need to change or at least every six months and updated to reflect changing needs; and agreed changes are recorded and action. Written protocols and guidelines to meet specialist requirements must have been agreed with specialist services, including psychologists, speech and language therapists and physiotherapists and be included on the care plan. All when required medication must have written protocol to support their use which has been endorsed by a clinician Excess medication must either be returned to the pharmacy for destruction or the balance recorded on the new medicine administration record (MAR) chart. A record of the current medication for each service user must be maintained on their care plan. The Commission must be informed without delay of the occurrence of any event in the E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Timescale for action July 30, 2005 2. 9 14 July 30, 2005 3. 20 13 June 30, 2005 June 30, 2005 4. 20 13 5. 20 15 June 30, 2005 May 30, 2005 (met) Page 23 6. 23 37 PIA - 136abc Manor Court Road Version 1.30 7. 8. 29 29 12 18 9. 35 18 care home which are adversely affect the well-being or safety of any service user. Service user bedroom must not be used for the storage of home equipment. All staff working in the home must be assessed as competent to use the hoisting equipment in place in the home. The training needs of the staff team must be assessed against the needs of people as they grow older. This must include Dementia Care and Stroke Awareness. May 30, 2005 July 30, 2005 November 30, 2005 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 Good Practice Recommendations PIA - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection 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 - 136abc Manor Court Road E53 S4474 PIA - 136a Manor Court Road V227541 120505 stage 4.doc Version 1.30 Page 25 - 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!