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Inspection on 19/01/06 for SCIC - 184 Drayton Avenue

Also see our care home review for SCIC - 184 Drayton Avenue for more information

This inspection was carried out on 19th January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The small-scale, domestic nature of the home appears much to the liking of the people there, particularly one person, who obviously enjoyed the relaxation of making herself cups of tea and watching what she wanted on the television, after coming in from her college course. Support continues to be provided in a low-key, discrete manner that nevertheless ensures that needs are met.

What has improved since the last inspection?

New carpets and painting has improved the home further; previous requirements have been addressed, reducing risks in identified areas. There are less unnecessary notices evident on walls.

What the care home could do better:

Storage of medication must be improved. There are still unnecessary notices, aimed at staff, on walls, which detract from the homely nature of the home. The notice board apart, information for staff should be available in ways other than displaying it on doors and walls. Individual, service user-friendly `life history/life story` books may also help in relaying information in a way that service users feel more involved. The provider must ensure that safety and security devices are used consistently.

CARE HOME ADULTS 18-65 SCIC - Drayton Avenue, 184 184 Drayton Avenue Stratford On Avon Warwickshire CV37 9LD Lead Inspector Martin Brown Unannounced Inspection 19th January 2006 15:00 SCIC - Drayton Avenue, 184 DS0000004467.V279320.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 SCIC - Drayton Avenue, 184 DS0000004467.V279320.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. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service SCIC - Drayton Avenue, 184 Address 184 Drayton Avenue Stratford On Avon Warwickshire CV37 9LD 01789 298709 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) Stratford & District Mencap Mrs Alexandra Louise Arnold Care Home 3 Category(ies) of Learning disability (3) registration, with number of places SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. NVQ Level 4 The Registered Manager achieve qualifications in both management and care including the Registered Managers Award, by 2005. Learning Difficulty Award The Registered Manager pursues a professional qualification in the field of learning difficulty by undertaking the Learning Difficulty Award Framework level 3 by 2004. Successful completion of above awards The Registered Manager to notify the National Care Standards Commission upon successful completion of the above and immediately in the event that the Registered Manager fails to achieve it or that the Registered Manager ceases, for whatever reason, to undertake the stated training. 24th August 2005 3. Date of last inspection Brief Description of the Service: Drayton Avenue is a three bed roomed semi-detached house which offers longterm accommodation for adults who have learning disabilities. The house has a lounge, dining room, kitchen, toilet and utility room on the ground floor. On the first floor it has three bedrooms, a bathroom and a staff sleeping in room. It has an open front and enclosed rear garden and is situated on the outskirts of Stratford on Avon within a large estate of social housing. The town centre is accessible by bus. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report is of the second unannounced inspection of the year at this home, and should be read alongside the previous inspection report, for a fuller picture. Where key standards have been assessed on the previous inspection and have been met, these have not necessarily been inspected on this occasion. The relative briefness of this report reflects the positive nature of this and the previous inspection. The inspection took place on a week day afternoon, and lasted three hours. During this time, I had the opportunity to speak to two service users, staff on duty, as well as a senior support worker and the manager. All were welcoming and helpful. One service user was not at home on this day. What the service does well: What has improved since the last inspection? What they could do better: Storage of medication must be improved. There are still unnecessary notices, aimed at staff, on walls, which detract from the homely nature of the home. The notice board apart, information for staff should be available in ways other than displaying it on doors and walls. Individual, service user-friendly ‘life history/life story’ books may also help in relaying information in a way that service users feel more involved. The provider must ensure that safety and security devices are used consistently. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 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. SCIC - Drayton Avenue, 184 DS0000004467.V279320.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 SCIC - Drayton Avenue, 184 DS0000004467.V279320.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): EVIDENCE: These standards have previously been assessed as satisfactory, and were not assessed on this occasion. There have been no new admissions in the past twelve months, and none are anticipated in the foreseeable future. SCIC - Drayton Avenue, 184 DS0000004467.V279320.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): 6,9 Clear and to the point individual care plans help service users’ needs and wishes to be met. Individual, service user-friendly ‘life history/life story’ books may further assist in empowering service users. If filled with photographs and souvenirs, and written in the first person, these could be a useful reference point for service users, and an indicator of what has been enjoyed, and possibly what has not been so successful. This becomes more important where a service user is becoming less able to consistently articulate such things. EVIDENCE: One service user was spoken with at length. Conversation with her demonstrated that she was supported in making choices and decisions, and later examination of records showed that relevant risk assessments, regularly reviewed, were in place to support and promote her independence. She was able to tell me who was on duty, and when, and what chores she did, and how she was supported in these. Care plans are in place, these continue to be primarily aimed at staff. SCIC - Drayton Avenue, 184 DS0000004467.V279320.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): 11,14 Service users continue to have a variety of activities that they enjoy and find beneficial. EVIDENCE: One person was keen to tell how she enjoyed college, and that she regularly attended a ‘gateway‘ club. She said that the things she was learning at college she found useful. Another was keen to show me her expanding music collection. Financial records showed expenditure on a number of social activities recently. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 11 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): 20 The sound administration of medication is compromised by the lack of a secure and dedicated storage for medication, separate from items not related to medication. EVIDENCE: Medication is kept on a shelf, in a locked cupboard, but alongside files and other non-medication documentation. Therefore the medication supplies are frequently exposed when the cupboard is opened for other reasons. It is dispensed from blister packs. Topical creams were on the shelf above; again, alongside non-medication items. Medication records were satisfactory. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 12 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 Service users are confident their concerns are listened to, and mechanisms are in place to help protect them from abuse and neglect. EVIDENCE: One service user was spoken with at length. She said she liked it at the home, had no complaints, and told me what she would do and who she would speak to if she did have any concerns. She was aware of the phone with large numbers, and was rung by her mother during the inspection. She was aware of the ‘quick dial’ number to ring another home in case of difficulties. She was also very complimentary about staff and the support they offered. The complaints book was seen; complaints were cross-referenced to ensure confidentiality where complaints were of a sensitive nature. The home has a copy of the organisation’s complaints and abuse policy. Vulnerable Adult issues have been dealt with appropriately. Personal finances of service users were recorded appropriately and accurately. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 13 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 continues to be clean, homely and comfortable and well-maintained, and a credit to the staff and service users. The homely ‘feel’ to the house is still compromised by the use of unnecessary notices aimed at staff in various places. EVIDENCE: Communal areas of the home have had new carpets and had been re-painted, and all areas of the house looked at were clean and tidy. There were less notices on display than previously, although there were still several that had arguably outlived their use. The manager agreed that many were better sited in staff information folders. All COSHH (Control Of Substances Hazardous to Health) items were stored appropriately, with appropriate recording. Laundry facilities are separate from the kitchen. One service user was waiting for staff support to do her laundry. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 14 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 The key standards in this section were not fully assessed on this occasion, other than to note that staff support enables service users to exercise choice and independence, and to be supported when this is needed. EVIDENCE: There were two staff on for a key period, enabling one service user to be supported to go shopping, whilst the other was supported in preparing tea. Support and advice was readily available when needed, as during this inspection, from senior support and management. The manager advised, in response to a previous requirement, that the home had had training and specialist input, still ongoing, in respect of understanding and managing dementia. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 15 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): 37,42 The home works to ensure the safety and well-being of those who live in it. Fire safety is compromised by a lack of clarity as noted below. EVIDENCE: The registered manager was able to demonstrate competency in discussion of issues relating to the running of the home. She advised that she has nearly completed both the NVQ4 qualification, as well as her Registered Manager’s Award, and is aware that she is to inform the Commission for Social Care Inspection when this has been done. One service user was able to demonstrate a clear knowledge of what to do in the event of a fire. There was a lack of clarity noted on the use, or otherwise, of a security device. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 16 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 X 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 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X 3 X LIFESTYLES Standard No Score 11 3 12 X 13 X 14 3 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 2 X X X X 2 x SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 17 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 YA20 Regulation 13(2) Requirement The home must review medication storage and ensure it complies with National Minimum Standards. The provider must ensure that use of security and safety items is clear and consistent. The manager must inform the commission for social care Inspection when she has completion her required awards. Timescale for action 24/02/06 2 3 YA42 YA37 13 9(2) 24/02/06 24/03/06 SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 18 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 2 Refer to Standard YA24 YA6 Good Practice Recommendations It is recommended that the use of notices, outside of the notice board, should be kept to a minimum. The development of ‘Life story books’ is recommended. SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Leamington Spa Office Imperial Court Holly Walk Leamington Spa CV32 4YB 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 SCIC - Drayton Avenue, 184 DS0000004467.V279320.R01.S.doc Version 5.1 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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