Inspection on 26/10/05 for Rivers Street

This inspection was carried out on 26th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Rivers Street 23/02/07

Rivers Street 08/02/06

Rivers Street 22/03/05

Rivers Street 20/10/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Rivers Street 44-45 Rivers Street Bath Bath & N E Somerset BA1 2QA Lead Inspector Sarah Webb Unannounced Inspection 26th October 2005 09:30 Rivers Street DS0000008166.V249262.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 Rivers Street DS0000008166.V249262.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. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Rivers Street Address 44-45 Rivers Street Bath Bath & N E Somerset BA1 2QA 01225 335066 01225 335066 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) New Era Housing Association Limited Mrs Helen Barbara Spurrell Care Home 14 Category(ies) of Learning disability (13), Learning disability over registration, with number 65 years of age (1) of places Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 14 persons with learning disability aged 18 years and over 22nd March 2005 Date of last inspection Brief Description of the Service: 44 - 45 Rivers Street is a registered care home managed by New Era Housing Association since April 2001. Bristol Churches Housing Association own the building and are responsible for the external maintenance whilst New Era are responsible for the internal decoration. The home provides accommodation to thirteen people aged from18 to 65 years and to one named person who is over the age of 65 all of whom have learning difficulties. The property is a Grade 1 listed Georgian building converted from two adjoining terraced houses, with the accommodation over four floors. There are two lounge areas on the ground floor, with the main kitchen and dining room located on the first floor. There is one double bedroom on the ground floor with the other twelve being single bedrooms. Two of the bedrooms have wash hand basins whilst the home provides sufficient bathrooms/showering facilities and toilets in the home for the other residents. Both a basement and second floor ‘flat’ offer a self- contained kitchen, while the ‘flat’ also has laundry facilities and a lounge. There are also separate laundry facilities available to the remainder of the residents. It is a short walk into the city centre which provides access to a park, shops, leisure facilities, and transport routes by bus and rail both locally and nationally. There is an attractive rear garden with a water feature, shrubs and seating, which is attended to by staff and residents. There is a sitting tenant on the third floor. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was carried out as an unannounced inspection and took place over a period of 1 day and a total of 6.5 hours. The inspection methods used included record checks, case tracking, discussion with the manager and staff, and 4 residents during a midday meal. An individual said they wished to be called by the term resident through this report. What the service does well: What has improved since the last inspection? There are procedures now in place for the outcome of all CRB’s to be recorded and to be accessed through the inspection process. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 6 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. Rivers Street DS0000008166.V249262.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 Rivers Street DS0000008166.V249262.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): 1&2 The home provides appropriate information to inform both existing and prospective residents about the service offered. The assessed needs and preferences of individuals are met and there are processes in place for the review of their care. EVIDENCE: The Statement of Purpose has been updated and reviewed. There is now inclusion of the South West Regional Planning, Quality and improvement Strategy. This centres on the philosophy, approach, promotion of rights, choice, inclusion and independence. There have been no new residents admitted to the home since the last inspection. During the last inspection the manager said that the funding authority’s assessment officers were in the process of reviewing individual’s placements with regard to a change to direct payments. Since those reviews there has been one individual receiving direct payments. However the manager said that this is to end when they complete a specific training placement. The manager is concerned that this will have an adverse effect on this individual as they have been in control and empowered since receiving direct payments; the manager has advocated on behalf of the individual in trying to secure further payments. Rivers Street DS0000008166.V249262.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 & 9 There is a clear and consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet individual needs. The home encourages individuals to make decisions regarding their lifestyle. The home has risk management procedures in place to ensure individuals are supported safely in taking risks. EVIDENCE: Since the last inspection all care plans have been symbolised. The manager said individuals were involved in the process of reviewing their care plans in line with the appropriate accessibility. It was evident through documentation and discussion with the manager and staff that service users needs are monitored and reviewed regularly. Relevant documentation was up to date with current changes. The manager said individuals are supported in making decisions by being given appropriate information. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 10 It was evident through discussion with individuals, observation, and record keeping that residents have made decisions regarding their lifestyle. The home continues to operate house meetings and the facilitation of separate advocacy meetings through an external agency. Since the last inspection, several residents have also been supported with individual advocates. Individuals attend differing committees such as The Bath and North East Open Forum and the New Era Regional Forum. The home continues to operate risk management strategies. These had been reviewed and were up to date. Comprehensive risk assessments in place covered areas of individuals’ health, social activities, mobility and financial aspects. Staff sign to agree they have read and understood risk assessments. Rivers Street DS0000008166.V249262.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): 12, 13, 14 & 17 The home offers individuals opportunities to lead active and fulfilled lifestyles which are both age appropriate and reflect their levels of independence. The home offers opportunities for individuals to take part in appropriate social and educational opportunities in order to enhance their lifestyle. The meals in the home offer variety and choice and encourage individuals to be aware of healthy eating options. EVIDENCE: There is no change regarding those individuals who continue to access day services through different venues. An individual has made a decision to resume attendance at another day service placement. Another person attends a work based training environment supported by direct payments. (The expected change in receipt of direct payments for this person has been previously recorded in Standard 2). There are no changes currently to the remainder of service users who attend a variety of voluntary work, and work placements. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 12 The manager is in dialogue with the local college regarding accessing new college courses for individuals. Individuals continue to access community facilities such as local shops, leisure centre, theatres, and membership to various societies. The home provides music therapy and aromatherapy sessions for several individuals. Transport continues to be provided by the use of taxis, buses and the house car. A parent has previously expressed concerns regarding the charge made for use of the home’s vehicle by residents. However the organisation is currently reviewing their transport policy. This will be followed up when the outcome of the review is established. The home went on holiday to Centre Parcs during the summer. Through discussion with both residents and staff it was apparent that the holiday was a special occasion for everyone. The manager said that individuals responded actively to the staff’s positive attitude whilst on holiday. It was evident that the home continues to provide meals based on a healthy eating philosophy. Sharing lunch with individuals and staff also evidenced this; the food was of a good quality and nutritious. Menus continue to be discussed on a weekly basis and residents are encouraged to help with the preparation of meals. Records indicated that the home has sought advice from a dietician in relation to the ongoing health needs of an individual. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19 The physical and emotional health needs of individuals are well met with evidence of multi disciplinary working taking place regularly. EVIDENCE: Through observation of records and discussion with the manager, it was evident that the home is continuing to support individuals with specific health care needs. Health care plans set out clear individualised procedures including monitoring processes, and support from specialist services advise staff in meeting individuals health needs. Funding authorities and advocates have been actively involved in discussion with individuals and staff when decisions need to be made. A resident spoken with who has recently undergone a major operation looked well and said they had returned to work. It is to be commended how the staff team have supported individuals recently through some difficult on going health issues. Rivers Street DS0000008166.V249262.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): 22 & 23 The home has a satisfactory complaints system with evidence that there are processes in place for individuals to voice concerns. Arrangements are in place for protecting individuals from possible risk of harm or abuse. EVIDENCE: There have been no complaints since the last inspection. There is a complaints policy with procedures in place for individuals to express concerns or to make an official complaint. A leaflet was displayed on a notice board. The majority of individuals are able to vocalise their views and said they would go to the manager if they had any concerns. The manager said she is committed to ensuring individuals are heard and that both opportunities and procedures are in place to encourage individuals to raise concerns. The manager and staff indicated that those not able to are monitored in relation to any changes in behaviour. There was a record of all staff having been through the process of having being police checked through the Criminal Records Bureau. A requirement has been met regarding a record to be kept of the outcome of all CRB disclosures. Although the home’s CRB record does not record outcomes, the organisation has put in place procedures for further records to be accessed during either an unannounced or announced inspection. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 15 The manager provided evidence that she is told of the outcome and involved in any discussion. The new staff member had an understanding of what action to take if an incident of abuse was reported. Staff have undergone training in relation to the protection of vulnerable adults. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 The home provides a comfortable, clean and homely environment. EVIDENCE: The property is a Grade 1 listed Georgian building converted from two adjoining terraced houses, with the accommodation over four floors. The home is close to local amenities and is in keeping with all properties in the area. It is a short walk into the city centre which provides access to a park, shops, leisure facilities, and transport routes by bus and rail both locally and nationally. A sitting tenant continues to occupy the third floor. The property is accessible to those living at the home- a stairlift operates from the ground floor to the first floor. The home is comfortably furnished, is safe and has recently been through a programme of redecoration. There is an attractive rear garden with shrubs and seating. The home has spent time in maintaining the garden with new plants, pots and a water feature. The manager said individuals were involved in developing the garden. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 17 The home benefits from a regular cleaner in order to maintain the cleanliness of the home. The disposal of waste is collected weekly under contract with Bath and North East Somerset Council. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 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): 31 & 32 There are clear procedures in place to inform staff of their roles and responsibilities. The home is making progress in assisting staff with a National Vocational Qualification in order to support service users with competent and qualified staff. EVIDENCE: There are robust induction procedures in place. A newly appointed staff member explained their induction process. They had attended appropriate statutory training and an in house induction checklist evidenced how the home introduced all aspects of their job description. They were able to relate their daily duties and responsibilities, and how they supported individuals. They said that both the manager and staff team was supportive and that there was a good atmosphere at the home. Recruitment records for the new staff member included application form, references and CRB check. The home will not meet Standard 32.6 regarding 50 of care staff achieving a National Vocational Qualification level 2 by 2005. However, there are currently two staff that are completing National Vocational Qualification Level 3, another staff member has completed LDAF and is to be registered, whilst a new staff Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 19 member is completing their probationary period and will also be registered for a qualification. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 20 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, 38, 41 & 42 The home is well run through a positive management approach. Record keeping in place is well maintained and up to date in order to protect individuals’ interests. There are procedures and protocols in place in order to ensure the health, safety and welfare of both service users and staff. EVIDENCE: The manager is continuing to work towards NVQ Level 4. She is actively involved in the implementation of New Era’s ‘Evolution’- a philosophy grounded in giving individuals more choice. It was evident that the manager continues to direct the staff team towards a person centred approach in supporting individuals. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 21 An action plan for the home sets out key successes over the past year in how staff have supported residents both on an individual and group basis. It was evident that the manager has a good knowledge of the residents needs and through positive discussion with staff and residents it was evident that they are happy and feel supported with the management of the home. Through the observation of interaction between staff and residents it was evident an ‘open’ culture exists whereby individuals have the confidence to speak up. It was also noted that those who may need additional support to be heard are given the extra time. Records seen included - care plans, health action plans, menus, visitors book, and risk assessments. These were well maintained, up to date and securely stored. Other records seen included the Control of substances hazardous to health inventory. This included all appropriate information, had been reviewed and staff had signed to indicate that they had read the policy and understood. A fire risk assessment is in place. The manager facilitates fire training for all staff. Records evidenced that all staff were up to date and had attended recent fire evacuation and had completed questionnaires as part of their training. Agency staff complete fire questionnaires. Records also evidenced that appropriate testing of fire equipment had taken place on a regular basis. Service checks had been carried out on specific disability equipment such as the stairlift and bath. Portable electrical equipment was in the process of being checked. Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 22 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 3 3 x x x Standard No 22 23 Score 3 3 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 3 x x x x x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score 3 3 X X X X CONDUCT AND MANAGEMENT OF THE HOME 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Rivers Street Score x 4 x x Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 3 X DS0000008166.V249262.R01.S.doc Version 5.0 Page 23 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. Refer to Standard Good Practice Recommendations Rivers Street DS0000008166.V249262.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Bristol North LO 300 Aztec West Almondsbury South Glos BS32 4RG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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