Inspection on 26/03/07 for Russell Street 40- 44

This inspection was carried out on 26th March 2007.

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

Russell Street 40- 44 13/12/05

Russell Street 40- 44 20/06/05

Russell Street 40- 44 05/01/05

Russell Street 40- 44 18/11/04

Russell Street 40- 44 04/02/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 40 - 44 Russell Street Cambridge CB2 1HT Lead Inspector Janie Buchanan Key Unannounced Inspection 26th March 2007 08:15 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 40 - 44 Russell Street Address Cambridge CB2 1HT 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) 01223 712261 01223 714297 www.cambridgeshire.gov.uk Cambridgeshire County Council Mrs Wendy Mary Bullivant Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (2) of places 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 13th December 2005 Brief Description of the Service: 40-44 Russell Street is a purpose built home for people with learning and physical disabilities; the home is owned and managed by Cambridgeshire County Council. The home consists of two houses, number 40 being a permanent home for four adults with learning disabilities, and number 44 providing short term respite accommodation for up to four adults with learning disabilities. 17 service users currently use this respite service. Both houses have their own kitchen/dining room and sitting room, four single bedrooms and toilet and bathing facilities. All service users accommodation is on the ground floor. The two houses are linked by an internal corridor and share an enclosed garden that is provided with patio furniture. The home is within a short walk of a range of local shops, pubs, restaurants, and a new leisure complex that includes a bowling alley and cinema. The centre of Cambridge is a short bus ride or drive, and Cambridge station is close by, giving easy access to London, Peterborough and other major cities. The charge for the service is currently £583 per week for permanent residential care. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the home’s key inspection for the year 2006/7 and was unannounced. The inspector arrived at 8.15am and met some service users as they had their breakfast and got ready to go to their respective day services. She interviewed four remaining service users and spoke with three members of staff. She undertook a brief tour of the premises and viewed a range of documents and policies. The inspector received 4 completed comment cards, requesting information about the quality of the service that had been filled in by service users. Three requirements have been made as a result of this inspection. What the service does well: What has improved since the last inspection? What they could do better: Care plans need to be much more detailed and identify clearly service users’ goals, and how these goals are to be met. This is vital if service users are to achieve their desired outcomes. Medication storage temperatures must be monitored to ensure medicines are stored appropriately and are of suitable quality for the treatment of residents. Under Regulation 26, Care Homes Regulations 2001, the provider (or a representative) is required to visit the home at least monthly and write a report of the visit: these reports must be left in the home and a copy sent to the CSCI. None have yet been received by the CSCI, despite this being a requirement from previous inspections. It is not clear why the provider continues to ignore this requirement, and the CSCI is seeking legal advice. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 6 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. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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): 1,2,4,5 Quality in this outcome area is good. Prospective service users have the information they need about the home. They have their needs assessed and a contract which tells them about the service. EVIDENCE: There is a statement of purpose and service users’ guide that give good information about the home and the services it offers. The service user’s guide is available in a simple format, with pictures, to help service users understand it. References to ‘National Care Standards Commission’ in the statement of purpose should be changed to read ‘Commission for Social Care Inspection’. Service users visit the home several times prior to their admission, to see if they like it. Information about service users is also obtained and copies of their needs-led assessment were viewed on the files checked. Each service user is issued with a contract that sets out the terms and conditions of their stay. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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 Quality in this outcome area is adequate. Care plans do not provide sufficient details to allow service users to realise their potential. However good assessment allows service users to take risks and enjoy an independent life. EVIDENCE: Two service users’ plans were viewed. The depth of information they contained was variable and the plans were not in a format that service users could easily access or understand. There was little evidence that service users or their families had been consulted about the plans. Although service users’ aims and objectives were recorded, there was no guidance for staff in how they were to be met. For example one service user’s aim was ‘to lose weight’ but there was no information about how this was to be done, what her target weight was, how often she was to be weighed, what food she was to avoid, how a dietician could be involved etc. This information is vital to enable service users to achieve their desired outcomes. Care plans did contain comprehensive risk assessments for service users. These had been recently been reviewed and staff had signed each assessment to indicate their understanding of them. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 10 Service users who completed the questionnaire confirmed that they made decisions about what they do each day, and one care plan contained evidence that a service user’s wish not to attend day services was respected. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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): 12,13,14,15,17 Quality in this outcome area is good. Service users lead busy and active lives and have the opportunity to develop and maintain important family and personal relationships. EVIDENCE: Routines are flexible and based on service users wishes. On the day of inspection itself one service chose to get up late and staff let her sleep in. Staff support service users to be independent and are currently assisting one service attend a gym regularly, and another to use public transport unaided. Service users are involved in daily living tasks at the home and take responsibility for cleaning, shopping and cooking. Service users also attend a variety of courses in the community that help them develop their living skills. Service users are supported to maintain contact with families and make friendships and relationships. One service user told the inspector her uncle and aunt visit her regularly, and that she also rings her boyfriend. Another service user told the inspector that she rings her niece on Scotland. Service users reported that they liked the food at the home and often help with cooking and shopping. Service users were observed making hot drinks and 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 12 preparing their breakfast. There was plenty food in fridges: this was of good quality and varied. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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): 18,19,20 Quality in this outcome area is good. Service users receive a range of healthcare services to meet their needs. EVIDENCE: Service users have access to health care services and those spoken to confirmed they regularly see their GP. During inspection itself one service user was waiting for a nurse from the learning disability partnership to visit her that morning. Staff are currently working with another service user, with success, to help her overcome her dislike of the dentist. Staff have received training in the use of physical intervention and individual management strategies are in place for service users. Service users reported that they were happy with the way staff treated them. Medication administration records (MAR) and storage was checked. There were a few gaps in the MAR sheets where staff had forgotten to sign that they had administered medication, and some handwritten additions to the sheets had not signed or dated. Medicines for respite service users are kept in a cupboard in the kitchen. The temperature in the cupboard should be monitored daily to ensure it does not get too hot, and impair the effectiveness of the medicines stored there. Staff spoken to confirmed that they had undertaken a ‘Pills and Potions’ medication training and there are comprehensive policies in place to offer guidance. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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, Quality in this outcome area is good. Service users’ concerns are taken seriously. EVIDENCE: Details of how to complain are contained in the home’s service user guide and the manager keeps a record of service users’ everyday complaints. Service users who completed the questionnaire stated that they knew how to complain and identified a number of people they would speak to if unhappy. One service user told the inspector that a member of staff had shouted at him the previous night. During the inspection a member of the day staff recorded his complaint for further investigation. There are weekly meetings with service users where they are able to raise concerns. Records viewed showed that staff had undertaken training in protecting vulnerable adults. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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, 30 Quality in this outcome area is good. The physical design and layout of the home enables service users to live in a safe environment that encourages their independence. EVIDENCE: The home was clean and well maintained on the day of inspection, and free from strong smells. Each service user has their own bedroom and access to a communal kitchen and sitting room and a large courtyard area that is surrounded by shrubs and plants. Garden furniture and a BBQ are available for service users. One service user told the inspector that he enjoyed coming out to the courtyard for a cigarette. There is a variety of specialist aids and equipment in the home to assist service users and help them be independent. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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): 32,34,35, 36 Quality in this outcome area is good. Service users are looked after by competent and well-trained staff. EVIDENCE: There is a minimum of three (and mostly four) staff on duty each day and two ‘waking staff’ at night to support eights service users. Scrutiny of the duty rota showed these staffing levels to be maintained and staff stated that they had plenty opportunity to spend time with service users. Both service users and their relatives spoke highly of staff. Comments included: ‘ staff make me happy’; ‘they are brilliant’ and I super staff- fall over backwards to help in every way they can’. However, the home does rely on agency staff to cover vacant shifts. Staff confirmed that they receive regular supervision that they found useful. One member of staff stated they would like more frequent supervision, as it was an important tool in monitoring care practices. It was of concern to note that the manger is solely responsible for supervising all 25 support workers and the inspector welcomes the forthcoming plans to delegate this task to senior members of staff. Training is given high importance and, in addition to all mandatory training, most staff have either completed or are working towards an NVQ level 3 in care. This is to be commended. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 17 The personnel files for two recently recruited members of staff were checked and each contained appropriate references, and CRB and POVA checks. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 18 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): 37,38,39,42 Quality in this outcome area is good. The management approach of the home creates a positive and inclusive atmosphere for service users and staff. EVIDENCE: Staff report the manager to be approachable and professional, and have a clear understanding of her role and the pressures she faces. There are fortnightly staff meetings where care practices are discussed and staff are able to raise concerns. Morale was good and staff reported that they enjoyed their work with service users. The home has a variety of methods to ensure a quality service is offered. Service user questionnaires are sent out annually and service users are involved in annual reviews carried out by the local authority at which they are encouraged to give their views about the service. Meetings are held weekly in number 40 for the permanent service users, and views of those on respite visits are sought. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 19 A number of records in relation to health and safety were checked (including fire tests, hoist servicing, gas safety) and found to be in good order. No major hazards were viewed around the home. 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 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 3 2 3 3 x 4 3 5 3 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 3 33 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 x 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 3 3 3 x 2 3 x 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 21 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 YA6 Regulation 15 (1) Requirement Service users’ plans must show their aspirations and goals, and how these are to be met. Plans must also evidence consultation with service users or their representative. The temperatures of the medicines storage areas must be monitored and recorded regularly to ensure a suitable environment exists Reports of visits by the provider carried out in accordance with this regulation must be kept in the home and a copy sent to the CSCI. Timescale of 14/02/06 not met. Timescale for action 01/05/07 2 YA20 13(2) 01/04/07 3. YA41 26 01/04/07 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 Good Practice Recommendations DS0000033505.V311723.R01.S.doc Version 5.2 Page 22 40 - 44 Russell Street Standard 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 40 - 44 Russell Street DS0000033505.V311723.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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