Inspection on 28/11/05 for Pineapple Road (9-9a)

This inspection was carried out on 28th November 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

Pineapple Road (9-9a) 26/07/07

Pineapple Road (9-9a) 30/09/06

Pineapple Road (9-9a) 22/02/06

Pineapple Road (9-9a) 04/11/04

Pineapple Road (9-9a) 01/07/04

Pineapple Road (9-9a) 13/01/04

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

CARE HOME ADULTS 18-65 Pineapple Road (9-9a) Amersham Bucks HP7 9JN Lead Inspector Chris Sidwell Unannounced Inspection 28th November and 13th December 2005 Pineapple Road (9-9a) DS0000023051.V273637.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 Pineapple Road (9-9a) DS0000023051.V273637.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. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Pineapple Road (9-9a) Address Amersham Bucks HP7 9JN 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) 01494 765079 h3001@mencap.org.uk H4037@mencap.org.uk Royal Mencap Society Ms Jane Cox Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 people with a learning disability, including one with a physical disability 4th November 2004 Date of last inspection Brief Description of the Service: Pineapple Road is a home for adults with a learning disability and is managed by Mencap. The home is situated in a quiet part of Amersham not far from local shops and a walk to the town centre. The home is registered for six people, being accommodated on two floors. There are four bedrooms on the first floor and two on the ground floor. One room has an en-suite. The home has a lovely garden to the rear of the property, which Service Users and staff have spent a considerable amount of time bringing it up to he standard it was on the day of the inspection. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the report of an unannounced inspection undertaken on the 28th November 2005 with a follow visit undertaken on the 13th December 2005 to look at recruitment files. The home’s policies and procedures and care planning documentation were examined and carers and residents were spoken to. The visit was timed to coincide with residents arrival home and the evening meal. Standards relating to care planning, individual choice, personal and healthcare support and staffing were assessed at this inspection. What the service does well: What has improved since the last inspection? What they could do better: It is recommended that the manager consider seeking training for staff to administer emergency treatment for people with epilepsy and also that they monitor the night staffing levels regularly if service users are unwell or unstable for any reason. The manager should also ensure that her plans to ensure that 50 of care staff hold the National Vocational Qualification in Care are followed through Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 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 Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 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 at this inspection but were met at the previous inspection undertaken on the 4th November 2004. EVIDENCE: Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 There are comprehensive care plans and risk assessments in place which help carers to support service users to maintain their independence as far as is possible. EVIDENCE: All service users have care plans. These are in the process of being updated and also further developed to reflect the fact that Mencap is hoping that the service users will be able to become more independent and move towards supported living in the future. Two care plans were examined in detail. Both had a needs assessment and care plans related to their identified needs. They were drawn up with the involvement of the service users and their families. The personal care records described the support that each service user needed. They had been reviewed on a six monthly basis. The shift leader on duty at the time of the inspection said that service users were given as much choice as possible and there was evidence in service users rooms that they are able to develop their own interests. An in house magazine, which has details of outings planned, has been developed in order to help service users choose which they would like to attend. Work has been undertaken by an advocacy agency to help service users to understand the concept of supported living Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 10 although this may have to be repeated if a significant period of time elapses before the decision to move to supported living is finally taken. There was evidence in the service users’ files of multi-professional team meetings where healthcare decisions had been necessary and service users involvement was clearly documented. There were risk assessments in the care plans and evidence that service users are helped to maintain their independence. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 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): These standards were not assessed at this inspection but were met at the previous inspection undertaken on the 4th November 2004. EVIDENCE: Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 The home provides service users with personal support, which helps them to maximise their independence. Service users healthcare needs are met although the home should consider training staff in the administration of rectal valium where prescribed if any service users have unstable epilepsy to protect them from prolonged seizures. The home’s medication procedures work well ensuring that service users receive their medication in a safe and timely way. EVIDENCE: The care plans showed that carers support service users to maintain their personal care. Carers were observed to give personal support and the service users said that they could choose which clothes to wear. There are no service users from an ethnic minority. There are both male and female staff and service users so it is possible for intimate care to be given by a staff member of the same sex as the service user. There is a key worker scheme in place and the carers spoken to say that this was discussed with the service users. The carers spoken to say that the daily routines were flexible. There was evidence in the records that service users’ healthcare needs are met. Both the care plans seen had evidence that the service users had had an annual health check. There was evidence that service users have access to local NHS services and are under the care of specialist outpatient departments where necessary. Service users’ weight is monitored on a regular basis. One Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 13 service user has epilepsy, which has not been as controlled during the last year as it has been in the past. She requires a monitor at night and her condition is being monitored. She has a risk assessment, which should be reviewed on a regular basis. The records also showed that service users had seen the optician and had hearing and dental checks. There are medication policies in place. The carer in charge on the evening of the inspection had had medication training and was aware of the policies. The medication administration charts and the dosette boxes both had photographs of the service user. There were no gaps on the medication administration records. Records are kept of medication entering and leaving the home. The staff are not trained to administer rectal valium and this training should be considered if any service users have unstable epilepsy. Both service users seen had had an annual medication review. Protocols, which have the General Practitioner’s support, are now in place governing homely remedies. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 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 the following standard(s): These standards were not assessed at this inspection but were met at the previous inspection undertaken on the 4th November 2004. EVIDENCE: Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 15 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 at this inspection but were met at the previous inspection undertaken on the 4th November 2004. EVIDENCE: Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The homes staffing levels, training programmes and supervision arrangements enable staff to support and develop service users ability. There is a need to ensure that staff are working for the National Vocational Qualifications in Care to ensure that they have they basic training to meet service users’ needs. The night staffing levels must be monitored closely whilst one service user’s epilepsy requires close monitoring. The home’s recruitment procedures work well and service users are protected from unsuitable carers. EVIDENCE: The staff spoken to demonstrated an understanding of service user’s needs and the interaction between service users and staff was observed to be positive and supportive. There are communication plans in the care plans, which describe service users’ main methods of communication, and the staff spoken to were aware of these. The staff spoken to were enthusiastic about their role and gave examples of positive changes that they felt had occurred in the home. One service user’s computer had been upgraded and he was clearly enjoying using it. One carer said that he felt that service users were talking to each other more and this was evident at the supper table. There was evidence in the records that regular multi-professional meetings are held and that the home has positive relationships with the relevant professionals. There are no trainees under the age of eighteen. The home does not yet meet the standard that 50 of care staff hold National Vocational Qualifications in Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 17 Care at Level 2 or above, although there is a plan in place for the newly appointed staff to achieve this. The staffing levels are such that there are two people on duty throughout the day and one at night. This meets the recommendations of the Residential Care Forum. The condition of the resident with epilepsy must be monitored and additional night staff employed if she is at risk at night. The staff team reflects the gender of the service users. The care plans and other documents were set out in a way which was accessible to service users. No staff are under the age of 18 and staff under the age of 21 are not left in charge of the home. There is a comprehensive induction programme, which the manager said met LDAF standards. The induction files of a newly appointed member of staff were examined and found to be complete. The training records showed that staff have the required training to support service users. All staff have now had infection control training. Four staff recruitment records were examined and all were found to contain the required information. Criminal Records Bureau checks had been undertaken and references had been sought before staff commenced work. Supervision has now been implemented and the staff spoken to confirmed that they receive regular supervision. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 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 Regular quality assurance visits to the home are undertaken by a representative of the organisation to improve the quality of care offered to service users. EVIDENCE: The manager said that all Mencap homes have an annual development plan and that this home was hoping to move to supported living in the near future. A requirement was made at the last inspection that unannounced monthly quality assurance visits are made by a representative of the organisation to the home and that a report describing the outcome of these visits is sent to the Commission for Social Care Inspection on a monthly basis. This requirement has now been met. Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 19 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 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 2 x 3 3 x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Pineapple Road (9-9a) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x DS0000023051.V273637.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? no 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 YA32 Regulation 19 Requirement The manager should ensure that staff are supported to obtain the National Vocational Qualification in Care at Level 2 or above. 50 of staff should hold this qualification Timescale for action 31/03/06 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 YA19 Good Practice Recommendations It is recommended that the manager consider seeking training for staff to undertake the administration of rectal valium for service users whose epilepsy is not well controlled. It is recommended that the night staffing levels are monitored closely and increased if necessary if service users are known to have epileptic seizures in the night. 2 YA33 Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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 Pineapple Road (9-9a) DS0000023051.V273637.R01.S.doc Version 5.0 Page 22 - 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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