Inspection on 24/02/06 for Robleaze

This inspection was carried out on 24th 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 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Robleaze 25/09/07

Robleaze 10/10/06

Robleaze 12/10/05

Robleaze 02/03/05

Robleaze 03/08/04

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 Robleaze 537-539 Bath Road Brislington Bristol BS4 3LB Lead Inspector Sandra Jones Unannounced Inspection 09:30 24 February and 2 March 2005 th nd Robleaze DS0000026552.V270096.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 Robleaze DS0000026552.V270096.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. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Robleaze Address 537-539 Bath Road Brislington Bristol BS4 3LB 0117 9720813 NONE 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) Mrs Susan Mary Robinson Mrs Claire Louise Luton Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. May accommodate up to 10 persons aged 18 - 64 years Date of last inspection 12th October 2005 Brief Description of the Service: Robleaze is a care home operated by Sue Robinson and managed by Claire Luton. It is registered to accommodate up to ten adults of both sexes with learning disabilities. The property is situated on a busy main road close to shops, parks, amenities and bus routes. Two houses were converted to accommodate the registered numbers and maintain its appearance of a domestic dwelling, which blends with its local environment. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This is the second unannounced inspection conducted over two days for this home. The residents at home and staff on duty agreed to give feedback on the standards of care and conduct of the home. The residents abilities to maintain their chosen lifestyle was observed as well as their interaction with staff and each other. Records and a tour of the premises were additional sources used to make judgements on the outcomes for residents. What the service does well: What has improved since the last inspection? What they could do better: Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 6 Requirements arising from this inspection are based on staff evidencing that they have received and understood the GSCC Code of Conduct. Training on aggression must be considered for all staff and staff’s training needs specific to them, as keyworkers must be incorporated onto supervision. In terms of the building repairs must be undertaken and the service provider should consider employing a person for day-to-day repairs. Regarding care planning, risk assessments must clarify the reasons for each restriction imposed and the manner in which residents right to privacy is respected must be added to their care plan action plan. 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. Robleaze DS0000026552.V270096.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 Robleaze DS0000026552.V270096.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): These standards were not examined at this inspection. EVIDENCE: Robleaze DS0000026552.V270096.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): 9 Residents are supported to develop independent lifestyles. For the resident that has restriction imposed, risk assessments must clarify each restriction and the reasons for limiting activities. EVIDENCE: Risk assessments are completed for any activity that may involve an element of risk. Overall, risk assessments in place focus of safety, crossing the roads and using equipment. Restrictions are imposed on one resident that has safety issues and because the resident will destroy property, residents are at risk. While the risk assessment incorporates the restrictions imposed, separate assessments must be conducted for each imposed restriction. Reactive strategies are in place for one resident that may exhibit challenging behaviour and to ensure consistency of care guidelines are provided for staff. Reports of significant events plot the effectiveness of the guidelines. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 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): 12,13 &15 Education and occupation is being sought for residents to undertake fulfilling activities and learn new skills. Residents use the local community, with the support of the staff to develop social inclusion. Staff assist residents to strengthen links with family and friends. EVIDENCE: The reduction in day care provision is having an impact on the home. The manager is taking steps to organise activities, occupation and education for residents. College courses are selected from the prospectus provided to enable residents to undertake activities and pursue hobbies and leisure activities. It was understood that college courses are selected for residents to learn new skills, socialise and to relax. Employment is being considered for one resident through external agencies. It is anticipated that this will open opportunities for other residents. There is a consultation process for residents to express their wishes including education and occupation goals. It was understood that at residents meetings, Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 11 suggestions are sought on goals and aspirations. Generally, it is the staff that make suggestions on their knowledge of the residents abilities. Residents prepare their lunch on the days at the home. On Thursdays residents have additional opportunities to cook at the cooking group. The residents currently accommodated are accompanied by staff outside the home. Residents use the local community, shops, hairdressing and newsagents and leisure activities are organised by the staff. Residents attend clubs and in the evenings. The manager stated that although a home’s vehicle is available to residents, in future residents will also use public transport on their 1:1 with keyworkers. It was understood from residents that their family are welcome by the staff at the home. One resident has some contact with friends and two spend time away from the home with relatives. Transport is provided by the home, where necessary, for resident to visit family, strengthening links with family. A record of professional visitors to the home is kept. The name of the person, the date and the nature of their visit is recorded. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 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&19 Personal support is provided in the individuals preferred manner and to support a person centred approach to meeting needs, the individuals right to privacy must be incorporated. The staff at the home monitor residents health care needs and recognise signs of deterioration. EVIDENCE: The currently accommodate residents require supervision and prompting with personal care. Assistance with hair washing, shaving and oral hygiene is mainly provided by the staff to residents. Needs assessments are completed and a person centred approach to meeting needs is used. While the key elements of choice, inclusion, rights and independence are incorporated. The manner in which privacy is respected must be added to action plans. Separate to the care plans are individual profiles that describe the person’s likes and dislikes including preferred routines i.e. times to rise and retire. A link between the profiles and care plans must be developed to fully support a person centred approach. The staff support residents with their health care needs. They are registered with a local G.P. and are accompanied by the staff. Female residents are invited for routine screening and on behalf of the residents the G.P. has signed a disclaimer for no further requests to attend. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 13 Two residents use continence aids, for one person its linked to behaviour and for the other its medical and appropriate specialist support is accessed. The residents are fully ambulant and do not require assistance with moving around the home. Robleaze DS0000026552.V270096.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): Residents views are sought by the staff and taken seriously. EVIDENCE: There were no complaints received at the home from residents and their representatives for investigation since the last inspection. Residents giving feedback were clear on the complaints procedure and the person to approach with complaints and concerns. Residents meetings are held monthly and the agenda for the meetings evidenced that opportunities exist for residents to raise group concerns and make suggestions. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 15 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): 24,26,27,28 &30 The property presents as a domestic dwelling and to fulfil its purpose, the property requires high levels of maintenance. There are repairs that must be undertaken to maintain a safe environment for the residents. Bedrooms are provided with sufficient furniture and fittings for residents to maintain their lifestyle. The communal space enables residents to gather together and share activities and for their private use. The ratio of toilets and bathrooms meet residents needs and offer personal privacy. The home is kept clean and free from unpleasant smells. EVIDENCE: Robleaze is situated on the Bath Road close to shops, amenities and bus routes. Originally two domestic dwellings adapted to provide accommodation and personal care to ten individuals. The property presents as a domestic dwelling, which blends with its immediate residential environment. While there is level access through the rear of the property, the home is not suitable for people that require equipment and aids, to maintain their independence. The property is Victorian and to fulfil the purpose of a care home, the building requires high levels of maintenance. While steps are taken to maintain the property, there are repairs that must be undertaken. A tour of the premises was undertaken and the following repairs were noted: The kitchen floor is torn Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 16 and unit doors are broken and in need of repair. There is a crack on the wall in room 2 and, the sink and carpet in room 3 are in need of attention. The vinyl in small toilet on the upstairs bathroom requires repair. In the bathroom the wire from the heater removed and the crack in the wall must be repaired. In room 6, the chest of drawers requires attention. The mastic around the bath in the downstairs bathroom must be replaced. Accommodation is arranged over two floors, with bedrooms on both floors and shared space on the group floor. With the exception of one, bedrooms are single. There is a double room, which is currently used by siblings. Bedrooms contain furniture and fittings suitable to meet the individuals needs. The combination of the home’s furniture and personal belongings reflects individual’s personality and interests. On the ground floor there are two toilets and one bathroom and on the first floor there are two bathrooms and two toilets. The ratio of people sharing the toilet is 2:5, which is above the NMS. 2:2 is the ratio of people sharing the bathrooms. The number of toilets and bathrooms are above the NMS, offering sufficient personal privacy. There is a lounge, two dining rooms and a quiet area, for shared activities and private use. In the lounge the residents can sit together and watch the television, in the quiet area there is seating for four people. Six people sit together in one dining room and four in the other. Communal space available is sufficient for residents to share activities and for their private use. The laundry room is sited away from the kitchen. The floor and walls are tiled for easy cleaning. Within the laundry room COSHH substances are kept in a secure cupboard. There are two washing machines, one is specifically for sluicing soiled linen, and two tumble dryers. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 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&36 The recruitment process is based on protecting residents from abuse. Members of staff must read and sign to indicate receipt and awareness of the GSCC Code of Conduct. Residents are supported by well-trained staff and to ensure, staff manage incidents of aggression consistently, training in aggression and violence must be considered for the staff team. Individual supervision ensures that staff fulfil the role and responsibilities of their role. To further develop staff skills, training requirements that specific to residents changing needs must be discussed during supervision. EVIDENCE: Since the last inspection two members of staff were recruited. Completed application forms, two written references, signed terms and conditions of employment and crb’s are held in their personnel files. Within the application form, members of staff must state their physical and mental fitness to fulfil the role and declare any criminal background. For staff that have spent convictions separate interviews are undertaken to establish the person’s suitability to work with vulnerable adults. A record of staff signature must be kept to evidence that a copy of the GSCC Code of Conduct was provided and understood. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 18 Training records for the staff employed at the home was examined. Members of staff must undertake the home’s induction programme, statutory training, with other specific training that meet the needs of the residents accommodated. This includes risk assessments, Health and Safety, aggression, diet and nutrition, infection control and medication administration. Regarding specific training, two staff have completed distance learning on aggression. As residents that may at times exhibit aggressive and violent behaviour are accommodated, members of staff must undertake the training to ensure they have the skills to consistently manage incidents of aggression. Vocational qualification is accessible to staff following completion of the training programme. Members of staff are registered onto the NVQ level 3 and five of the seven support workers employed have or are undertaking the qualification, which is above the NMS in terms of the level and number of staff. Members of staff consulted confirmed that individual supervision with line managers’ occurs three-four weekly and the service provider undertakes monthly supervision with the manager. Copies of the monthly visits conducted at the home are sent to the CSCI office. Through supervision, staff’s training needs should be discussed with their line manager. As key workers, the category of needs within their key group should be discussed during supervision, to ensure key workers have the skills and capabilities to meet the needs of the residents in their group. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 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): 38,41&42 The management approach ensures that residents benefit from a positive and consistent culture. Records that relate to finance are well managed and up to date and staffing levels are organised to meet the needs of the residents. Procedures in place assist to provide a safe environment for the residents. EVIDENCE: Members of staff were consulted on the conduct of the home. It was reported that the manager and service provider were approachable and described the systems that ensured consistency of care. Additional comments were made regarding the training available that ensured staff have the skills to meet the residents needs. The staff’s understanding of their roles as key workers was stated as developing residents independent living skills. The rota in place is organised to ensure that there is a senior member of staff on duty in the mornings with two support workers. When the manager is on duty the staffing levels remain the same until 5:00 pm. From 3:00 pm onwards there are two staff on duty until 10:00 when the person that sleeps in the premises is on duty. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 20 Facilities for the safekeeping of cash and valuables exist at the home. Currently residents have cash in safekeeping and from the sample check conducted, the records are well managed and up to date. Individual schedules are in place and specify the weekly fees with the sources that contribute towards the charge. The home’s Health and Safety policy commits to providing safe and healthy conditions, equipment and procedures to its residents and staff. COSHH risk assessments are in place for chemicals used at the home. Instructions on complying with the legislation and the steps to be followed in the event of an emergency are detailed. A record is maintained of injuries sustained at the home by staff and resident. The name of the person and details of the accident are recorded in the accident log. Risk assessments are completed for staff to complete household tasks safely. The risk factor to the task is listed and an action plan formulated to reduce the level of risk. Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x 2 x Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 x 3 3 x 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 x 17 Standard No 31 32 33 34 35 36 Score x x x 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Robleaze Score 2 3 x x Standard No 37 38 39 40 41 42 43 Score x 3 x x 3 3 x DS0000026552.V270096.R01.S.doc Version 5.0 Page 22 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 2 Standard YA34 YA35 Regulation 18(4) 18 (c)(1) Requirement Members must sign to indicate receipt and their understanding of the GSCC code of Conduct a) Training in aggression must be considered for all staff. b) Training needs must be discussed during supervision Repairs must be undertaken to maintain a safe environment. The individuals right to privacy must be incorporated into their person centred plans For each restriction imposed, risk assessments must clarify the reasons for restricting the activity. Timescale for action 30/05/06 30/06/06 3 4 5 YA24 YA18 YA9 23 12(3) 13(4) 30/10/06 30/06/06 30/06/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA24 Good Practice Recommendations The service provider should consider employing a handy person to maintain the property Robleaze DS0000026552.V270096.R01.S.doc Version 5.0 Page 23 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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