CARE HOME ADULTS 18-65
Polesworth Group - Long Street, 68 68 Long Street Dordon Warwickshire B78 1SL Lead Inspector
Maggie Arnold Unannounced Inspection 9th February 2006 10:00 Polesworth Group - Long Street, 68 DS0000004448.V283153.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 Polesworth Group - Long Street, 68 DS0000004448.V283153.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. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Polesworth Group - Long Street, 68 Address 68 Long Street Dordon Warwickshire B78 1SL 01827 899508 01827 892500 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) Polesworth Group Homes Limited Mr Stewart Harrison Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 16th August 2005 Brief Description of the Service: 68 Long Street, also known as The Terrace, is part of Polesworth Group Homes, which was established as a Limited Company in June 1991, with the aim of providing accommodation and support services to adults with learning disabilities. The home is one of three care homes, housed in adjoining terraced properties owned by the company on Long Street. 68 Long Street accommodates three service users. There is a light modern kitchen with a utility at the rear, a cosy dining room with a feature fireplace, and lounge with open plan staircase leading to the first floor. The first floor has one double bedroom, one single bedroom and a light modern bathroom. Externally there is a small rear garden with lawn, flower-beds and shrubs. The home is situated in a residential area of Dordon near to shops and other local facilities including a public house, a library and a health centre. As the current residents are able to safely maintain many aspects of their independence, 68 Long Street is only staffed for parts of the day. Staff are available 24 hours a day at 64-66 Long Street and the residents from 68 Long Street can call upon these staff should any need arise. Polesworth Group - Long Street, 68 DS0000004448.V283153.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 a weekday between the hours of 10.00am and 3.00pm. The inspector shared her time between 68 and 70 Long Street, which is an adjoining Polesworth Care Home. The inspector spent the majority of her time in the home with residents from both 68 and 70 Long Street. One member of staff, who shares her time between the two homes, was on duty at the time of the inspection. What the service does well: What has improved since the last inspection?
No requirements and just one recommendation arose from the previous inspection. The recommendation, regarding fire safety practice, has been actioned. Since the last inspection the manager has, where relevant, implemented requirements and good practice recommendations arising from
Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 6 inspections of other sister homes. For example, the home’s medication and records of residents’ finances had recently been reviewed and updated as necessary following an inspection at one of the adjoining homes. 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. Polesworth Group - Long Street, 68 DS0000004448.V283153.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 Polesworth Group - Long Street, 68 DS0000004448.V283153.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): 5 Residents are provided with individual contracts. This helps to ensure that the residents’ are aware of the agreement they are entering and that their legal rights are into protected. EVIDENCE: All of the residents are provided with an individual folder containing a copy of the home’s Service User Guide, contract and copy of the resident’s most recent six monthly review. All of the residents keep their folder in their bedrooms. One resident showed the inspector his folder. The contract included details of what is and is not included in the fees. The manager has recently added information to the folders, which advises the resident of welfare payments, made by the Company in acknowledgement of household chores they undertake on a weekly basis. The manager advised that the format (written and or pictorial) of the contracts vary according to the needs and preferences of the resident. Polesworth Group - Long Street, 68 DS0000004448.V283153.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&9 Residents assessed and changing needs and personal goals are reflected in their care plans. This ensures that residents receive an individual package of care. EVIDENCE: One care plan and accompanying records were seen on this occasion. The care plan detailed the resident’s assessed needs and personal preferences. There were details of preferred daily routines, likes and dislikes. The file held support plans covering communication methods, any concerns regarding mobility, behaviour and the management of medication. A letter on file evidenced that arrangements were in place to formally review the resident’s placement at the home. The file also contained pictorial care plans, which the resident finds easier to understand. For example, the pictorial care plan contained photographs of the resident undertaking various tasks and activities, which forms part of their weekly routine. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 10 Risk assessments and risk management strategies are routinely reviewed and updated accordingly. Discussions with one resident evidenced that he knew whom to telephone in the event of an emergency and the location of a list of telephone numbers. It is recommended that key telephone numbers be coded into the home’s telephone so that the residents can just press the relevant buttons. This will help to make the process quicker and easier for all of the residents. Polesworth Group - Long Street, 68 DS0000004448.V283153.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): 12,15-17 Residents are given opportunities to participate in varied appropriate activities. The home is pro-active in encouraging personal friendships and relationships. This works promoting a positive self-image and feeling of well being. Nutritious, varied and balanced meals promote the health and well being of the residents. EVIDENCE: The residents undertake a variety of appropriate and fulfilling activities. Activities include attending a day centre facility and or college that offers a variety of educational, training and social activities. The number of days attended and activities undertaken vary according to the individual resident’s interests and ability. Other activities include general and personal shopping, visits to the cinema and theatre, visiting friends, attending church, meals out and voluntary work in a local charity shop. The residents also enjoy annual holidays, to which the Company contributes towards the cost. Residents are fully involved in choosing when and where to go on holidays. All of the residents have areas of responsibility within the home. In addition to being responsible for their bedrooms, residents assist in the day-to-day
Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 12 running of the home. As noted in the section headed Choice of Home, residents’ responsibilities for household tasks are specified in the Service User Guide and care plans. The type and degree of responsibility is based on risk assessments and, as far as possible, the preferences of the resident. As noted in the same section, residents receive a weekly payment for the domestic tasks they undertake. Residents spoken to said that they were happy to undertake household tasks and receive additional income. Residents confirmed that the staff helped them to maintain contact with friends and family. Visitors are welcomed to the home at any time providing it isn’t very early or late in the day. This is to protect the privacy and dignity of residents who may still be in bed or preparing to retire for the night. It was particularly noticeable how friendly and supportive the five residents were towards each other. The residents and staff member said that should one resident be ill or upset other residents rallied around to help them. For example, one resident had recently been particularly unwell and the residents volunteered to undertake some of their household tasks. The Commission received one completed relatives/visitors comment card. The comment card, which is produced by the Commission, asks questions about the service such as “Do the staff/owners make you welcome and have you ever made a complaint?” The feedback form advised that there were no concerns regarding the service and that “The level of care and support given to …is excellent”. The inspector had the opportunity for a brief telephone conversation with the respondent who said that they found the “Care (by staff) to be genuine, liked how the home encouraged … independence and that only the best is good enough”. The respondent also said that they made occasional unannounced visits and always found the home to have a good atmosphere and to be spotless clean. The home is run and staffed at a level that promotes residents’ independence and individual choice. For example, staff are not always on duty in the home. The residents knew that a staff member is always on duty in an adjoining sister home if they needed support or had any concerns. Discussions with residents and staff member combined with records seen confirmed that, unless subject to risk assessments, there are very few restrictions in the home. Residents respect the privacy of each other’s bedrooms and unless necessary, staff do not enter residents’ bedrooms without their permission. Residents’ bedroom doors are lockable and staff hold a master key for use in the event of an emergency. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 13 The bathroom door is locked by means of a small bolt. The manager advised that steps have been taken to fit a locking device that can be easily overridden. Two of the residents open their own mail and request advice or support from staff as necessary. Personal post is given to the third resident who opens the envelopes which is then read by a staff member and, if necessary dealt with in accordance to the resident’s wishes. The inspector had the opportunity to have lunch in the home with all of the residents from 68 and 70 Long Street. It is a regular occurrence for the five residents to share a mid day meal. It is pleasing to note that it is common practice for the staff and residents to eat together. The meal was a very relaxed affair with residents assisting as appropriate. Residents commented on how much they enjoyed the meals and confirmed that a choice of meals and snacks were always available. As on the previous visit, the kitchen was clean, well ordered and stocked with a variety of varied and nutritious food. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 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 Residents benefit from discrete, individually based care and support that is provided in a sensitive manner by the staff. The home has appropriate systems in place for the safe management and storage of medication. EVIDENCE: Records seen demonstrated that, subject to risk assessments, the home encourages residents to be as independent as possible. Two residents require minimal prompts with personal care. The level of support for the third person varies according to the individual’s changing needs. For example, staffing input has been increased in order to offer additional support to the resident who has recently been unwell. Residents spoken to confirmed that they talked to staff if they had any worries or wanted extra support. A discussion took place regarding how recently introduced fluid charts might be improved. For example, records could be improved by details such as amounts, half or a full cup, and times that the fluid was taken. The manager advised that a pro-forma for fluid records was in place the day after this inspection.
Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 15 The inspector was also informed that the manager had recently reviewed the overall management of the medication. A check of the medication confirmed that staff adhere to the home’s policy and procedures for the safe storage and management of medication. For example, the medication was securely stored and records were up to date. It is recommended that the home consider keeping current patient information leaflets in a folder. This would make it quicker and easier for staff to refer to the information. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 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 In addition to a complaints procedure there are a number of systems in place, which encourage and support the residents to voice any complaints or views regarding the service. EVIDENCE: The home follows Polesworth Group Homes complaints policy and procedures. The document was not seen on this occasion. Neither the Commission nor the home has received any complaints in the last twelve months. Residents spoken to said that they felt confident that their views would be listened to if they were “worried or wanted to complaint”. Although not fully familiar with the complaints process the residents were aware that they could talk to their key worker or, if more appropriate the manager or Chief Executive of the home. The home is pro-active in encouraging residents to voice any concerns or complaints. For example, the Chief Executive of Polesworth Group Homes has regular residents meeting from which the staff and manager are excluded. Unannounced monthly visits from the Company Secretary also helps to ensure that the residents are given an additional opportunity to voice their views regarding their satisfaction with the service. Refer also the section headed Conduct and Management of the Home. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 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): Not assessed on this occasion. EVIDENCE: As on previous visits the home was warm, clean, comfortable and homely. Two residents were busy undertaking their household chores when the inspector arrived at the home. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 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 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): Not assessed on this occasion. EVIDENCE: The staff member on duty at the time of the inspection was well informed and cooperated fully in the inspection process. It was noted that the staff member worked in a relaxed but polite and respectful manner with the residents. For example, the staff member always said please when requesting residents to assist in various routines and thank you when the task was completed. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 19 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 The home has effective quality assurance and quality monitoring systems in place that include the views of the residents. This helps to ensure that the service is run in a manner that takes into account the views of the residents. EVIDENCE: 68 Long Street has a number quality assurance and monitoring systems in place. For example, the Chief Executive of the Polesworth Group Homes visits the residents four times a year. The manager and staff are excluded from these formal meeting. The manager advised, although verbal feedback is given to him, the Chief Excecutive retains the records of the meetings. In accordance with the Care Homes Regulations 2001: Regulation 26, a representative of the Company also makes regular unannounced visits to the home. A copy of the findings of the Regulation 26 visit is forwarded to the Commission.
Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 20 The manager receives regular formal supervision and an annual appraisal from the Chief Executive of the Company. An annual performance review helps to monitor the standard of the service over the previous twelve months and agree on development plans for the forthcoming year. The meetings and visits help to ensure the accountability of the manager and staff and that the service is run in a manner that takes into account the views of the residents. Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 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 Standard No Score 1 x 2 x 3 x 4 x 5 3 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 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 x x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x x x 3 x x x x Polesworth Group - Long Street, 68 DS0000004448.V283153.R01.S.doc Version 5.1 Page 22 No 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. Standard Regulation Requirement Timescale for action 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 YA9 Good Practice Recommendations It is recommended that key telephone numbers be coded into the home’s telephone so that the residents can just press the relevant buttons. This will help to make the process quicker and easier for all of the residents. 2 YA19 It is recommended that the home consider keeping current patient information leaflets in a folder. This would make it quicker and easier for staff to refer to the information. Polesworth Group - Long Street, 68 DS0000004448.V283153.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
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