Inspection on 30/09/06 for Pineapple Road (9-9a)

This inspection was carried out on 30th September 2006.

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 no outstanding requirements from the previous inspection report, but made 3 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) 22/02/06

Pineapple Road (9-9a) 28/11/05

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 Gill Gentles Unannounced Inspection 30th September & 13th October 2006 09:30 Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 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.V304071.R01.S.doc Version 5.2 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.V304071.R01.S.doc Version 5.2 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 www.mencap.org.uk Royal Mencap Society Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 6 people with a learning disability, including one with a physical disability 22nd February 2006 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. There are good transport links with buses running past the end of the road and the town has a train station with main line trains and tube trains into London. 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. The current fees for this home appear to be £236.51 per week. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was unannounced and took place on the 30th September and 13th October 2006. The second day’s visit was because the manager was on leave during the first day, therefore staffing records were unavailable for inspection. Policies, procedures, home records and care records were examined. The home manager and staff were spoken to. Interactions between service users and staff were observed. All six-service users were spoken with throughout the course of the inspection. The care of two service users was case tracked and care practices were observed. Documentation pertinent to the health and welfare of service users and health and safety around the home were viewed. A tour of the environment pertinent to the two service users being case tracked was carried out, this included bedrooms, bathing and toileting facilities as well as the communal areas. The commission received comment cards from service users and a health care professional. The evidence seen and comments received indicate that this service meets the diverse needs [e.g. religious, racial, cultural, disability] of individuals within the limits of its Statement of purpose. What the service does well: Prospective service users are given basic information that will help them make an informed choice about where to live. The organisation has an appropriate assessment policy and procedure to ensure that all prospective service users are assessed. Service users have been issued with license agreement that informs individuals of the service they should receive. Personal care needs of the service users are identified through the Care Plans to ensure individual needs, wishes and preferences are met. Risk Assessments are in place to ensure service users are safe. Service users are enabled to access the community and a range of activities to support their lifestyle choices and promote independence. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 6 Service users are supported to maintain contact with family and friends, to keep important social contacts. Meals and meal times are dependent on personal choices with staff support to enable service users to prepare a healthy nutritious balanced diet. Service users are offered personal, physical and emotional support as and when required and records are clearly maintained. Effective complaints procedures are in place to ensure that issues raised by service users and their representatives are listened to. Adult protection is appropriately managed to ensure that service users are not placed at risk of harm. In general the environment creates a homely, comfortable and safe home for service users. Staff records identify that staff have the competencies and qualities required to meet service users’ needs. The home’s recruitment policy and practices support and protect service users from potential harm. Service users receive the appropriate support from well-supported and supervised staff. 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. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 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.V304071.R01.S.doc Version 5.2 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): 2,5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users are given basic information that will help them make an informed choice about where to live. The organisation has an appropriate assessment policy and procedure to ensure that all prospective service users are assessed. Service users have been issued with license agreement that informs individuals of the service they should receive. EVIDENCE: There had not been any new admissions to the home since the last inspection. There is a robust policy and procedure in place in the manual to provide guidance on the process of admitting new service users, which looked like a comprehensive and detailed process. Two-service users’ care was case tracked, in the personal files were the existing needs assessments that were carried out prior to moving into the home. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 9 All service users have a license agreement between themselves and Mencap signed and dated when the service users moved into the home. There was no evidence that service users are aware of the current fees they pay. Discussion with the manager highlighted the fact that she was also unaware of the overall fee paid by individuals. The manager and service users are aware of their personal contribution, which is set by the local authority. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 10 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. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Personal care needs of the service users are identified through the Care Plans to ensure individual needs, wishes and preferences are met. Risk Assessments are in place to ensure service users are safe. EVIDENCE: Two-service users’ care was tracked throughout this inspection. Service users’ plans were clear and concise and identified individuals assessed needs, and clearly incorporated how the staff support the individuals. Service users spoken with reported that they are involved in contributing directly to their care plans. Person Centred Plans are in the process of being developed with service users who keep a copy in their own rooms. Eventually Person Centred Plans will supersede care plans. One service user was keen to show their Person Centred Plan and was able to explain the process and information it contained. The Care Plans in situ were found to be very detailed, and specific to each individual’s needs. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 11 Each service user has an identified key-worker. Care Plans identify how service users’ personal care needs are met and when support is required. They are written in the first person in the most; however, one was found to be written in the first and third person which needs to be amended. Service users confirmed that they make all their own choices about their lives and how the home is run to the best of their ability considering their diverse needs, with maximum support and encouragement from the staff team. Risk Assessments have been completed and reviewed regularly. All service users are encouraged and supported to minimise the risks and maintain an independent lifestyle to the best of their personal abilities. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are enabled to access the community and a range of activities to support their lifestyle choices and promote independence. Service users are supported to maintain contact with family and friends, to keep important social contacts. Meals and meal times are dependent on personal choices with staff support to enable service users to prepare a healthy nutritious balanced diet. EVIDENCE: Service users spoken with confirmed that they are offered support to ensure that they are assisted in making choices regarding their education, day care, community links, relationships, leisure activities and other aspects of individual lifestyle choices. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 13 Evidence was gathered through care plan documentation, discussions with service users and care staff and from observations throughout the inspection visit. Service users had made positive choices regarding their individual involvement in Gateway club, going out for meals, shopping trips etc. Several different activities had been planned for the next few weeks; these were to include a meal at a local pub and one service user going away to family. A balanced diet is offered to all service users and will take into account their individual dietary requirements and preferences. This was confirmed through observation, discussions and documentary evidence. Service users spoken with confirmed that they meet as a group every Tuesday evening to select the following weeks’ menus. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 14 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): 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are offered personal, physical and emotional support as and when required and records are clearly maintained. Medication has improved and is now managed well, ensuring that service users receive the medicines they require to keep them healthy and well. EVIDENCE: Care plan documentation viewed of the service users case tracked had been updated to ensure that all health care needs were identified and service users were being supported in accessing external resources as and when required. All service users are registered with a local GP who refers them on to other health care professionals if required. Service users access community facilities for Dental, Optical and Chiropody as required. Health care needs were discussed with care staff and it was confirmed that appropriate support is offered. Service users also have access to a Speech Therapist and/or Psychologist. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 15 Service users are encouraged and supported to access medical professionals through either the GP or the Community Learning Disability Team. A record of health care appointments is maintained for those service users who have attended, such as routine doctors, dental, optical appointments, with a brief description of the outcome. Medication policies and procedures are in place and accessible by all staff. Clear guidelines for each service user are in place for administering all medication including PRN medicines. Medication is stored in each service user’s room in a safe with a combination lock. Service users have given permission to staff to access the medication for administration. Medication for the two-service users case tracked was found to be stored precisely and all appropriate records were in place. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Effective complaints procedures are in place to ensure that issues raised by service users and their representatives are listened to. Adult protection is appropriately managed to ensure that service users are not placed at risk of harm. EVIDENCE: The home has appropriate policies and procedures in place to ensure service users’ views are listened to. The home has received three complaints since the last inspection that have been handled appropriately. Detailed records of the complaints and the outcomes were being maintained. The commission has received no information concerning complaints made to the service-by-service users or their representatives. Service users are protected from abuse by the home’s policies and procedures. 5 out of 5 members of staff have received Protection of Vulnerable Adults training. There have been two Protection of Vulnerable Adults issues raised since the previous inspection that were reported anonymously to care line which social services received and investigated appropriately. Minutes of the strategy meetings are held in the home and evidence of actions carried out. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 17 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): 24,30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. In general the environment creates a homely, comfortable and safe home for service users. EVIDENCE: 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. The bedrooms of the two service users who were cased tracked were viewed. In general they were found to be homely, personalised and of a domestic nature, with natural and electric lighting and heating. One of the rooms had an en-suite shower room. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 18 The communal rooms have a homely ambience; service users confirmed that they were involved in choosing the decoration and the layout of the furniture. The home has two bathrooms on the first floor and a toilet on the ground floor. Appropriate infection control systems are in place and all staff have received training. There were no odours detected in the home. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 19 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): 34,35,36. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home’s recruitment policy and practices support and protect service users from potential harm. Staff records identify that staff have the competencies, qualities and training required to meet service users’ needs. Service users receive the appropriate support from well-supported and supervised staff. EVIDENCE: Personal records were viewed for all five permanent staff working in the home and for the relief/bank staff on the books. All files contained the appropriate information required to ensure service users are protected from harm. Pineapple Road manager and Mencap have a pro-active approach to staff training. All staff have completed the LDAF induction foundation course and are awaiting the outcome. 33 of staff are qualified to NVQ level 2 and 33 are in the process of completing it. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 20 The mandatory training of the permanent staff has improved. Out of five permanent staff there are:• Food Hygiene - 4 • Fire Awareness - 4 • First Aid - 5 • Manual Handling - 4 • Infection Control – 2 The other staff are all booked on courses by Unique training, a company Mencap use, and who seem to be responsible for ensuring training is up to date. Other training is promoted and encouraged, these include challenging behaviour, Person Centred Planning, epilepsy awareness etc. All staff files viewed clearly incorporate supervision records. There was a contract explaining that supervision will take place six-weekly. Records and staff confirmed that supervision takes place as stated in the contract. There were very few or no supervision records for the relief staff whose service is frequently utilised in the home. The manager must ensure that regular relief staff receive the appropriate formal supervision. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 21 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): 37,39,42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home appears to be managed well by the manager giving clear leadership to the team and promoting continuity of care to service users and improving standards all round. EVIDENCE: Since the previous inspection in February 06 the acting manager Joanna Watson was appointed as the permanent manager on the 01.05.06. The acting manager is in the process of applying for registration with the Commission. Joanna is in the process of completing the Registered Managers Award NVQ level 4. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 22 The acting manager has overall responsibility for the day-to-day operation of the home with the assistance of a deputy, who is due back from maternity leave in October 06. Regular unannounced proprietors’ visits are carried out monthly and reports are forwarded to the Commission. Actions are identified for rectification. It was unclear as to whether Mencap have carried out an annual quality audit on the home during the past 12 months. Previously they had implemented service reviews, which were carried out by managers and assistant service managers. A selection of health and safety certificates was perused, such as fire, gas and portable appliances. It was noted that the Portable Appliance testing is due December 06. There were a few shortfalls in maintaining weekly Fire alarm checks and the home had no evidence to confirm whether a Legionella test had taken place. It is required that the manager ensures the Fire Alarm tests are carried out weekly and that annually the water is tested for legionnaires. It is also recommended that monthly health and safety audits are carried out and recorded. These must incorporate all rooms in the home identifying any potential hazards and the action to rectify them. During the course of the inspection, it was noted that the wardrobe and shelving unit of one of the service users being case tracked was in a precarious position and potentially dangerous to the individual and needs rectifying. It is required that the wardrobe and shelving unit are replaced with a more sturdy version by the home. Risk Assessments were found to be in place for individual service users and generically to the home and reviewed regularly. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 23 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 3 3 X 4 X 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X 2 X X 2 X Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 24 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 2 Standard YA36 YA42 Regulation 18(2) 13(4) (ac) Requirement The manager must ensure that regular relief staff receive the appropriate formal supervision It is required that the manager ensures the Fire Alarm tests are carried out weekly and that annually the water is tested for legionnaires. It is required that the wardrobe and shelving unit in one of the bedrooms on the ground floor is replaced with a more sturdy version by the home. Timescale for action 20/11/06 15/12/06 3 YA42 13(4) 15/12/06 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 2 Refer to Standard YA36 YA42 Good Practice Recommendations It is recommended that the manager ensures relief/bank staff used regularly are formally supervised. It is also recommended that monthly health and safety audits are carried out and recorded. Pineapple Road (9-9a) DS0000023051.V304071.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Oxford Office Burgner House 4630 Kingsgate, Cascade Way Oxford Business Park South, Cowley Oxford OX4 2SU 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.V304071.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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