Inspection on 22/02/06 for Portland Crescent Residential Home

This inspection was carried out on 22nd February 2006.

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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Portland Crescent Residential... 19/03/09

Portland Crescent Residential... 26/02/07

Portland Crescent Residential... 23/11/05

Portland Crescent Residential... 07/03/05

Portland Crescent Residential... 03/11/04

Portland Crescent Residential... 19/02/04

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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 Portland Crescent Residential Home 43 Portland Crescent Woodbridge Suffolk IP12 4DZ Lead Inspector Jane Higham Unannounced Inspection 22nd February 2006 15:00 Portland Crescent Residential Home DS0000024474.V284208.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 Portland Crescent Residential Home DS0000024474.V284208.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. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Portland Crescent Residential Home Address 43 Portland Crescent Woodbridge Suffolk IP12 4DZ 01394 388011 01394 388011 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) www.mencap.org.uk Royal Mencap Society Mr Andrew Harvey Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 23rd November 2005 Brief Description of the Service: Portland Crescent was first registered in 1992 and provides care and accommodation to four adult service users with a learning disability. The home is owned and administered by Mencap and is situated on the outskirts of the town of Woodbridge, close to local shopping facilities and within walking distance of the town centre. The town of Ipswich can be accessed by train or bus and the coastal town of Felixstowe is some eight miles away. The home itself is a large, modern, purpose built, dorma style bungalow which provides very spacious accommodation for the four service users who live there and there is one very spacious bedroom on the first floor, accessible by a stair lift if required. Communal accommodation includes a large conservatory which leads out onto the rear garden, a spacious lounge, a dining room and a domestic style kitchen. The home has a large secure garden to the rear of the property. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection of Portland Crescent residential home, a four bedded residential resource for adults with learning disabilities, situated on the outskirts of the town of Woodbridge. The home is owned and administered by Mencap, who provide services for people with learning disabilities on a nationwide basis. This was the second inspection in the inspection year 2005/2006 and was carried out on 22 February 2006 over a period of two and a half hours. All key standards have been assessed over the two inspections and this document should be read in conjunction with the report of the Unannounced Inspection which took place on 23 November 2006. The home was inspected against the National Minimum Standards: Care Homes for Adults and the Care Standards Act 2000. The National Minimum Standards and Care Homes Regulations 2001 are referred to throughout this report and any non compliance identified. The Assistant Manager was present at the time of the inspection and assisted with the inspection process. On this occasion, key standards not assessed as part of the previous inspection were examined and any requirements made at that time were re-assessed. The Inspector had the opportunity to speak to members of staff, residents and one family member who was visiting on the day. What the service does well: The home provides very person centred and individualised care in a homely and domestic setting. Residents are supported to maximise their independence and to fulfil their potential. The home actively supports residents to make decisions and choices around their daily lives and to play a role in its daily life. Practices within the home promote the rights and responsibilities of individuals and service users are supported by competent and qualified staff at a level which is appropriate to ensure that individual care needs are met. The home has a very open approach to the service it provides and encourages the involvement of both advocates and family members. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 6 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. Portland Crescent Residential Home DS0000024474.V284208.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 Portland Crescent Residential Home DS0000024474.V284208.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): 2 The home ensures that the needs and aspirations of prospective residents are thoroughly assessed before they are admitted on a permanent basis. EVIDENCE: Standard 5 was assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. The home has a very static resident group and as such no new admissionshave taken place for the last two years. All pre-admission assessments for existing residents have been assessed as part of previous inspections and have been found to contain appropriate and detailed information on assessed care needs of prospective residents. One visiting social worker was able to confirm how well the home met their client’s needs. Portland Crescent Residential Home DS0000024474.V284208.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): 7 Residents living at the home can expect to be supported to make choices around their daily lives. EVIDENCE: Standards 6 and 9 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2006. Through the inspection, the home was able to evidence that residents are actively encouraged and supported to make choices around their daily lives. The assistant manager and a resident were able to cite instances where they had been encouraged to make choices around holiday destinations and how they would like to spend their personal monies. Some residents had active advocacy support from family members whilst another resident had a very “pro-active” advocate from an outside agency. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 10 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): 16 and 17 The home actively promotes the rights and responsibilities of residents and ensures that service users are offered a varied and nutritious diet. EVIDENCE: Standards 11,12, 13,14 and 15 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. The home was able to evidence that two of the current residents have requested and been provided with keys to their bedrooms. Any mail received is delivered to the recipient unopened although staff will assist with the reading of mail etc. where requested. The home was able to evidence that residents are involved in the day to day running of the home and on the day of the inspection one resident was assisting a staff member to prepare the evening meal. During the inspection, it was confirmed that the home does not provide a planned menu of meals but all four residents are consulted on a daily basis on what options they would like for the evening meal. Residents are also provided with a packed lunch to take to day services during the week. Due to the small number of residents accommodated, meals are provided on a Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 11 domestic style basis, although a record is maintained to evidence what each resident has eaten. These records evidenced that residents were provided with a varied and nutritious diet. One resident commented that although they liked the meals provided, they felt that they could not always choose what they wanted. The home was able to evidence that meals consisted of fresh vegetables and meat supplied locally. All staff involved in the preparation of resident meals have received training in Basic Food Hygiene. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 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): Not assessed as part of this inspection. EVIDENCE: Standards 18, 19 and 20 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 13 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): Not assessed as part of this inspection. EVIDENCE: Standards 22 and 23 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. Since the previous inspection, no complaints have been received by the Commission in relation to this service. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 14 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 The home provides residents with both private and communal accommodation which is well maintained, comfortable and appropriate to meet their assessed needs. On the day of the inspection, cleanliness and hygiene could have been better in one area of private accommodation. EVIDENCE: Standards 24-30 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2006. These standards were reassessed during this inspection. The home is situated in a quiet residential area of Woodbridge within easy walking distance of the town centre. The home is purpose built and takes the form of a four-bedroomed dorma style bungalow situated in an elevated position, surround by well maintained, secure gardens. There is limited car parking to the side and front of the property. The home has a good provision of communal accommodation all of which is wheelchair accessible. There is a spacious and attractive living room, which is maintained to a good standard of decorative order and repair, is comfortably furnished and equipped with a large screen television. Leading from this room is a large conservatory, which again Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 15 is well furnished and leads out onto the enclosed garden. There is a well equipped domestic style kitchen with a dining room sited alongside. Whilst only one of the four bedrooms has ensuite accommodation, the home has a walk-in shower room and a communal bathroom which has recently been fitted with a new assisted bath. It was obvious from the inspection, that residents are encouraged to personalise their bedrooms and in general all four bedrooms are maintained to a good standard of decorative order and repair and are furnished to the tastes of the occupant. During the previous inspection, several issues were identified in relation to the health and safety of a resident occupying the large bedroom, with ensuite facilities, which is sited on the first floor of the building. Requirements were made in relation to the need for urgent repairs to certain fixtures and fittings. On this occasion the home was able to evidence that all these repairs had been carried out and a detailed risk assessment had been produced in relation to the equipment and personal belongings of the occupant which may pose a risk to their health and safety. Since the previous inspection, the home had produced an improvement plan which gave an account for all repairs and maintenance work which had been carried out on the building since the beginning of the year. In general, all areas of the home were maintained to a satisfactory standard of cleanliness and hygiene. It was identified however, that one bedroom was not maintained to a satisfactory standard of cleanliness and unhygienic conditions were found in the ensuite lavatory. It was agreed with the assistant manager that the occupant would be supported to clean their room on a more frequent basis and the cleaning of the ensuite facility would be included as part of the daily cleaning schedule for staff. Since the previous inspection, a kitchen cleaning rota had been produced which detailed the frequency at which equipment should be cleaned. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 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 and 33 The home is staffed at an appropriate level to ensure the health, safety and well being of residents. Service Users are supported by qualified and competent staff members. EVIDENCE: Standards 33, 24 35 and 36 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. On the day of the inspection, residents were being supported by the assistant manager and two support workers. The staffing rota correctly reflected the number of staff on duty. The Registered Manager was on a training day. During the night period, one member of staff is on duty on a “sleep –in” basis. The home was able to evidence that it has a high level of staff with NVQ qualifications either at Level 2 or 3. At the time of the inspection, all staff bar one had either achieved an NVQ or were working towards this qualification. Staff were confident in their roles and carried out their duties in a professional but warm manner. One visiting family member commented that communication between care staff and relatives/advocates was good and that they were always made to feel very welcome and worked together to provide the best possible care for service users. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 17 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 Residents, their advocates and stakeholders can be assured that their views will be actively sort in relation to the quality of the service provided. Whilst in general the health and safety of residents is protected attention needs to be paid to the risk involved in untested electrical items. EVIDENCE: Standards 41 and 42 were assessed as part of the previous Unannounced Inspection which took place on 23 November 2005. The home continues to provide the Commission with monthly quality assurance reports as required by Regulation 26 of the Care Homes Regulations 2001. Additionally the home was able to evidence that satisfaction questionnaires are circulated to resident’s parents and stakeholders on an annual basis. During the previous inspection, it was identified that following an accident involving a service user, the relevant risk assessment was not reviewed. On this occasion it was identified that this was still the case. The Commission Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 18 advises that individual risk assessments relating to residents should be reviewed frequently and following any accident or incident involving the service user. In the previous inspection, concerns were raised over the electrical equipment being used by the one resident at the home. In response to these concerns a risk assessment of all fixtures, fittings and equipment in this room was carried out and identified that several items of electrical equipment bought by the service user had not been subject to Portable Appliance Testing. The Inspector was assured that this equipment would be tested as part of the annual PAT testing programme which was due to take place in April 2006. Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 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 Standard No Score 1 x 2 3 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 x 23 x ENVIRONMENT Standard No Score 24 x 25 x 26 x 27 x 28 x 29 x 30 2 STAFFING Standard No Score 31 x 32 3 33 3 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x x x x x x 3 x x 2 x Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 20 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 YA30 Regulation 23(2)(d) Requirement Timescale for action 22/02/06 2 YA42 13(4)(c) 3 YA42 13(4) The Registered Persons must ensure that all areas of the home are maintained to a satisfactory standard of cleanliness and hygiene. The Registered Persons must 01/05/06 ensure that all electrical appliances within the home are subject to an annual Portable Appliance Test. The Registered Persons must 22/02/06 ensure that relevant elements of a resident’s risk assessment are reviewed following any accident in which they are involved. This is a repeat requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 21 Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Portland Crescent Residential Home DS0000024474.V284208.R01.S.doc Version 5.1 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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