Inspection on 13/12/05 for Pia - Princes Street, 46

This inspection was carried out on 13th December 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 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Pia - Princes Street, 46 04/11/08

Pia - Princes Street, 46 26/11/07

Pia - Princes Street, 46 27/11/06

Pia - Princes Street, 46 08/07/05

Pia - Princes Street, 46 12/01/05

Pia - Princes Street, 46 06/08/04

Pia - Princes Street, 46 23/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Pia - Princes Street, 46 46 Princes Street Nuneaton Warwickshire CV11 5NW Lead Inspector Sheila Briddick Unannounced Inspection 13th December 2005 08:15 Pia - Princes Street, 46 DS0000004447.V274079.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 Pia - Princes Street, 46 DS0000004447.V274079.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. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Pia - Princes Street, 46 Address 46 Princes Street Nuneaton Warwickshire CV11 5NW 02476 353581 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 Ms Angela Rynn Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th July 2005 Brief Description of the Service: 46 Princes Street is a registered care home for seven adults with learning disabilities. People in Action provides 24 hour care and support for the people living in the home. The home is located in the centre of the town of Nuneaton, North Warwickshire, and as such is close to all local services and facilities the town has to offer. It is a two-storey building with gardens to the front and rear of the property. There are 8 single bedrooms, one having a shower en-suite facility. One of the bedrooms is used as the sleeping/office for staff. Two of the bedrooms are located on the ground floor. The ground floor bathroom/toilet has a walk-in shower facility and bath, which has an electrically operated bath seat. There is another shower facility and separate toilet and bathroom/toilet located on the first floor.The shared facilities in the home consist of a large lounge, kitchen with dining area and well maintained garden to the rear of the property. The garden provides separate areas of privacy, has a greenhouse and a vegetable patch. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 13th December 2005 between the hours of 8.15am and 12.00 midday. During this time the inspector had opportunity to meet with service users, observe the interactions between service users, staff and their environment, tour the home and examine documents relating to the service users and management of the home. The views of service users and of the staff supporting them at the time of the visit are included in this report. What the service does well: What has improved since the last inspection? What they could do better: Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 6 No requirements were made at this visit. Good practice recommendations were discussed with the manager and staff regarding healthcare and quality monitoring systems. 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 - Princes Street, 46 DS0000004447.V274079.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 Pia - Princes Street, 46 DS0000004447.V274079.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): These standards were not assessed on this occasion. EVIDENCE: Pia - Princes Street, 46 DS0000004447.V274079.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 and 7 The care planning system is adequately providing staff with the information they need to satisfactorily meet service users assessed and changing needs. Service users are receiving appropriate support to make decisions regarding their lives, which is promoting their rights and responsibilities. EVIDENCE: Two care plans and personal diary records were examined on this occasion and showed that care plan programmes are in place to meet assessed needs. The care plan review system has been reviewed since the last inspection visit and changes have taken place. This includes documented monthly meetings taking place between the service user and their keyworker. Recording who attended the meeting and areas of need discussed. Care plan records show that programmes in place to meet needs are evaluated during these meetings and any necessary action to meet changing needs identified. Team leaders and the registered manager monitor monthly review meetings between the service user and keyworker at three monthly and six monthly intervals. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 10 Service users are being involved in decision-making regarding their financial management support and management of risk and signing their agreement to decisions made when possible. Strategies in place to minimise risk to individuals are being agreed and reviewed with specialist services and this includes psychology and learning disability services. There is evidence of the home and service user’s day services working together to meet individual needs and choices. This includes a change of day service provision to meet identified and changing needs. During the visit staff were seen to respect individual choices of service users and offered support appropriately and in a manner that respected rights and responsibilities. There was a relaxed atmosphere in the home and service users were being supported to get ready for the days activities at a pace that respected their needs and choices and in a manner that was sensitive and promoted independence. Care plan diaries recorded choices made by service users and house meetings are taking place monthly where house issues are discussed and agreed. Service users talked about plans in place for the coming holiday period, which included individual leisure activities and visiting relatives. Staff responded promptly and appropriately to service users requests for personal money. Pia - Princes Street, 46 DS0000004447.V274079.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): 15 and 17 The people living in this home can be sure that they have the necessary support they need to maintain relationships with family and friends in such a way as to promote their privacy and independence. The meals in this home are good offering both choice and variety and catering for special dietary needs. EVIDENCE: During the visit service users were happy to talk about their family members and how they maintain relationships with them. This included being able to visit them, having regular visits from family members to the home and spending holidays with relatives. Staff spoken with were aware of the individual support service users needed in maintaining relationships with their family members and friends. Service users were comfortable and relaxed with each other and spoke of friends they had at their day services, some of whom they were hoping to see at a planned party over the holiday period. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 12 Menus records were examined and found to be varied and well balanced. Service users said that the food was, ‘nice’ and told the inspector about the breakfast choices they had made that morning. Service users were seen to be able to access drinks and snacks independently and staff offered drinks to those not able to do so themselves. Service users having breakfast at the time of the visit were not hurried and received appropriate support as necessary from staff. Sufficient stocks of fresh and processed foods were available and being stored safely in clean cupboards, fridges and freezers. Pia - Princes Street, 46 DS0000004447.V274079.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): 19 and 20 The people living in this home can be sure that they will be supported and encouraged to take control of and manage their own healthcare in a manner that promotes their rights and responsibilities. Medicine management in this home has improved and ensures service users receive their medicine as prescribed. EVIDENCE: Care plans seen show that service user’s healthcare needs are being reviewed with them on an annual basis and to meet changing needs. The views of service users are well documented including discussion and advice given to them when they refuse treatment for healthcare and dental care. Associated risks with decisions service users are making have been discussed with healthcare specialists and action is being taken to support service users with developing an awareness of the risks involved and action that may be necessary in the event of emergency treatment. Healthcare specialist support sought includes specialist consultants, psychologists and community learning disability nurses. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 14 Service users are accessing all NHS Healthcare facilities, which includes the primary care team, dentists, opticians, community and specialist nurses. Attendance at routine screening clinics is supported if this is what the service user wishes. The introduction of the Mental Capacity Bill on 1 April 2007 and the implications this may have regarding supporting service users making decisions about their healthcare was discussed and a good practice recommendation has been made. Medication records were examined and found to be up to date and in good order. There are written protocols in place for staff to follow when administering medicine to be given ‘as required’ and these are reviewed annually or as needs change by psychology services and the home’s GP. Pia - Princes Street, 46 DS0000004447.V274079.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 The home has a satisfactory complaints system and can evidence that service users views are listened to and acted upon. EVIDENCE: Service users have access to the complaints policy and procedure, which is in written and symbol format meeting their communication needs. A record of any complaint made is maintained including documentation of the outcome of action taken to resolve the complaint. There had been no complaint made since the last inspection visit. Service users said that were happy living in the home. Regular house meetings are taking place with service users and records of house meetings show that their views about house issues are sought and they have opportunity to air their views regarding the service provision. Pia - Princes Street, 46 DS0000004447.V274079.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): These standards were not assessed on this occasion. EVIDENCE: Pia - Princes Street, 46 DS0000004447.V274079.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): 34 The people living in this home can be sure that the policy and procedure for recruiting staff is protecting them from harm by the people caring for them. EVIDENCE: People in Action has effective and established procedures for the recruitment of staff. This includes POVA and Criminal Record Bureau checks taking place on all staff prior to their working in the home. A record is maintained in the home of all recruitment processes that take place for an individual and this includes CRB information, copies of references, application forms and interview report. There had been no external recruitment to the home since the last inspection visit. New staff working in the home had done so through People in Action’s internal transfer policy. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 18 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): 39 and 42. Steady progress is being made by the service in developing processes for measuring success in meeting its aims and objectives. Policies and procedures for safe working practice are ensuring that the health, safety and welfare of the people living and working in the home is being protected and promoted EVIDENCE: There is good documentation in this home to demonstrate that systems for monitoring the quality of the service are steadily being established. This includes identifying action plans to issues raised during the monthly Provider visits to the home, recording the outcomes of complaints, maintaining records of compliments received and producing an annual development plan for the home. Monitoring systems have been introduced for measuring ongoing competency of staff when administering medicine, for maintaining up to date records of medicines held in the home and for in house auditing of service users personal monies. The care plan review process involves service users views and decisions being made by service users are documented well. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 19 Service users were familiar with the inspection process and the role of the inspector. Action had progressed satisfactorily to meet requirements within agreed timescales that were made at the last inspection visit. Good practice recommendations were discussed with the registered manager regarding evaluation of the development plan for the home at the end of the identified period and seeking the views of professionals involved in the care provision. There are established processes in place for ensuring safe working practice with staff demonstrating good practice in this area and an understanding of health and safety legislation. Training records show that staff are trained in moving and handling, fire safety, first aid, food hygiene and infection control. Risks in the home are assessed and reviewed on a regular basis and staff have clear guidelines to follow for safe working practice when handling cleaning products and using equipment, including hoists. A motorised wheelchair has recently been purchased to enable staff to move a person using the chair more easily and safely, especially up slopes and hills. Staff said they had found this more comfortable to use. The control of risk of Legionella and regulation of hot water temperatures is monitored and documented. There is documented evidence of regular maintenance checks on central heating systems, fire safety equipment and electrical equipment used in the home. All fire safety records were up to date and in good order. Pia - Princes Street, 46 DS0000004447.V274079.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 X 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 X ENVIRONMENT Standard No Score 24 X 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 3 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X 3 3 X X X 3 X X 3 X Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 21 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 YA6 Regulation 14 Requirement An annual assessment of needs, using the homes own assessment tool, must take place with service users whose placement is not funded by the local authority. (Agreed timescale at last inspection 30/01/06) Timescale for action 30/01/06 Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 22 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 YA19 YA39 YA39 Good Practice Recommendations It is recommended that the registered manager becomes familiar with the Mental Capacity Act prior to it coming into force on 1 April 2007. It is recommended that the views of other care professionals involved in the service provision be sought as part of monitoring the quality of service. It is recommended that the registered manager produce a written evaluation of the outcome of the home’s development plan at the end of the identified period. Pia - Princes Street, 46 DS0000004447.V274079.R01.S.doc Version 5.1 Page 23 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. 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