Inspection on 08/02/06 for Rivers Street

This inspection was carried out on 8th February 2006.

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 26/10/05

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 8th February 2006 10:00 Rivers Street DS0000008166.V282102.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 Rivers Street DS0000008166.V282102.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. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 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) None 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.V282102.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 14 persons with learning disability aged 18 years and over 26th October 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.V282102.R01.S.doc Version 5.1 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 2 hours. The inspection methods used included record checks, case tracking, discussion with the manager, service users and staff. Three people at the home were being supported with daily household tasks. Those spoken to indicated that they were looking forward to celebrating an individual’s birthday that same day. It was evident that since the last inspection, service users have been working towards their involvement in the homes recruitment process through support from an advocacy agency. This is good practice and will be put into practice when interviews take place for 2 new staff shortly. What the service does well: What has improved since the last inspection? There are no requirements and recommendations from the last inspection. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 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.V282102.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 Rivers Street DS0000008166.V282102.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 assessed needs and preferences of individuals are met and there are processes in place for the review of their care. EVIDENCE: There has been no change in that there have been no new individuals admitted to the home since the last inspection. One person has been reassessed by their funding authority and has received 6 flexible hours of direct payments in order that that they may investigate other means of accessing meaningful activities. The manager said some individuals have also asked to be supported through an external advocacy agency in order to express their wishes for direct payments to fund alternative activities. The manager said there are other people who are in the process of being reassessed, as their needs have changed in relation to their health care and mobility needs. Rivers Street DS0000008166.V282102.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 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. EVIDENCE: Standards 7 and 9 were assessed at the last inspection; both standards were met and were given a score of 3. The home is continuing with the development of a person centred approach towards the process of care planning. The home continues to review individuals’ care on a 6 monthly basis and relevant documentation was up to date with current changes. It was evident through discussion with the manager that individuals are involved in the review and development of their care plans. Although care plans have been symbolised on an individual basis, one person plans to make use of their digital camera to use a pictorial format. Other people have also shown an interest in pursuing this method. Rivers Street DS0000008166.V282102.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): 12, 15, & 16 The home continues to offer individuals opportunities to lead active and fulfilled lifestyles that are both age appropriate, and reflect their levels of independence. The home supports individuals with maintaining relationships with families and friends. There are processes in place through the daily routines of the home for the promotion of individuals’ independence. EVIDENCE: Individuals continue to access day services through different venues. There have been changes to 2 peoples activities; one person has completed a work based catering placement, and is now attending work experience within the same field. This person is also supported in looking for paid employment through an external agency. Another person has started a placement with the Salvation Army carrying out voluntary duties. The remainder of individuals continue to attend a variety of employment, and work placements. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 11 The manager has set up a fortnightly social craft group that includes people from other homes in the organisation. The manager said individuals have also received funding to attend a college placement once a week. It was evident through observation and discussion with the manager that the home supports the maintenance of family relationships. A family member was visiting on the day of the inspection, and several telephone calls also from a family member indicated that the staff have positive communication with relatives. Families are often invited to join the home for meals and included in social events. On the day of the inspection it was an individual’s birthday and arrangements were in place to celebrate this with friends invited to the home. Arrangements are also in place to support visits made to friends outside of the home. Bedroom and front keys have been issued to individuals; it was evident that some people choose not to use their keys whilst for others it is part of their everyday lifestyle. It was evident through observation and discussion with individuals that they are involved with household responsibilities; people were involved in helping with the midday meal. Rivers Street DS0000008166.V282102.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): 18 & 20 Personal support is offered in such a way to promote and protect individuals’ privacy, dignity, independence and preference. The systems for the administration of medication are robust with comprehensive arrangements in place to ensure medication needs are met. EVIDENCE: The home continues to support individuals with their personal support needs. These are recorded comprehensively in care plans setting out individuals’ specific needs. The manager said people were involved in setting out, both the support needed and how they wished it to be implemented in their care plans. A new staff member explained the medication process; there were clear and comprehensive procedures in place. Staff sign to say they have read and understood information provided. The staff member said they had received instruction and were now considered competent to administer medication. There were clear records kept of individuals’ medication needs and the administration of medication. Control measures in place indicated that the home monitors all medication administered and that protocols in place are followed. Disposal of medication was up to date with appropriate procedures in place. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 13 There were arrangements in place for individuals to take their medication with them when attending day placements and on social leave. Records in place evidenced that medication is signed for by both individuals’ and their families. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 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 has been no change since the last inspection in that there have been no recorded 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. It was evident through observation that there are positive relationships between residents and staff with open communication channels for individuals to feel confident in expressing concerns. An external advocacy agency also supports residents through regular meetings. There are organisational policies and procedures in place for the protection of vulnerable adults including a whistle blowing policy for staff. The manager and staff have attended relevant training regarding protecting service users from abuse baring a new staff member who is booked to attend. There was a record of staff who have been through the process of a police checked through the Criminal Records Bureau. 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.V282102.R01.S.doc Version 5.1 Page 15 Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 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 organisation has carried out enquiries regarding the status of a sitting tenant living on the third floor of the home. The home is comfortably furnished, is safe and maintains a high level of cleanliness through a cleaner who is employed on a daily basis. Over the past year the home has undergone a considerable redecoration/refurbishment programme. At the time of this inspection, the roof was being replaced. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 17 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 The home has robust recruitment procedures in place with service users supported in their involvement in the process. The home has a comprehensive induction programme for new staff to follow in order that they are well informed as to how the home is run, and the support needs of individuals. The training needs of staff are sufficiently met. EVIDENCE: The manager said there has been a positive response to a recent recruitment drive. Interviews are planned for 2 full time posts and service users are to be included in the process. The advocacy agency supporting service users on a regular basis has been working with individuals towards their involvement in the homes recruitment process. Service users have produced an information pack for new staff describing the daily routines of the home. New staff are to be invited to a task orientated interview involving supporting service users. They will be observed and a proforma is to be completed by those individuals supported in order to make a decision as to the most suitable candidate. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 18 The home has currently used a regular relief staff member, and staffs from the organisation outreach team to cover vacant shifts. Records examined evidenced that the manager implements a comprehensive induction process for all new staff. Training records indicated that staff have completed mandatory requirements of first aid, health and safety, fire, manual handling and food hygiene. The manager and deputy are booked to attend an update on food hygiene. There has been no change in that two staff are continuing to complete National Vocational Qualification level 3 whilst other staff are completing LDAF. Rivers Street DS0000008166.V282102.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 There are procedures in place for the views of individuals to be listened to. EVIDENCE: There are organisational processes in place to gain the views of service users. Dimensions UK send out surveys to individuals annually. The findings of the surveys are published and feedback is given through differing committees such as The Bath and North East Open Forum and the organisation’s Regional Forum. An organisational magazine is also published reporting positive changes in individuals’ lives. The homes processes involve 6 monthly reviews involving both service user and their family. Both house and advocacy meetings also give the opportunity for views to be heard. Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 20 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 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 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 x x x x LIFESTYLES Standard No Score 11 x 12 3 13 x 14 x 15 3 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 x 4 x x x 3 x x x x Rivers Street DS0000008166.V282102.R01.S.doc Version 5.1 Page 21 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.V282102.R01.S.doc Version 5.1 Page 22 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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