CARE HOME ADULTS 18-65
SCIC - 62 Station Road 62 Station Road Studley Warwickshire B80 7JS Lead Inspector
Martin Brown Unannounced 6 September 2005 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 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 Stationary 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 - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service SCIC 62 Station Road Address 62 Station Road Studley Warwickshire B80 7JS 01527 857477 01789 296724 Telephone number Fax number Email 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 Ms Mandy Whitby Care Home 8 Category(ies) of Learning Disability - (8) registration, with number Learning Disability - Over 65 (1) of places SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 14 February 2005 Brief Description of the Service: 62 Station Road, which was previously also known as The Maltings, provides residential accommodation for eight adults with learning difficulties. It is part of the Studley Project, which is run by Stratford Care in the Community (Stratford and District Mencap). 62 Station Road is a detached purpose built home, situated about a mile form the village centre of Studley. There is good access to local transport and local community facilities. On the ground floor, there is a large lounge, a dining room, laundry room, one bedroom with en suite facilities and a kitchen. On the first floor there are a further seven single bedrooms for service users, a shower room, bathroom, two toilets and a room used by staff as an office and sleeping in room. There are six residents currently all are men.There is a garden to the rear, which has ramped access, laid to lawn with barbecue area and patio. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection lasting approximately three hours, on a midweek late afternoon/early evening. Staff and residents of the home were welcoming and helpful. All service users were seen and spoken with. What the service does well: What has improved since the last inspection? 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. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 2,4,5 Service user assessments and introductory processes help ensure that admissions are positive and successful. EVIDENCE: A new service user has settled in, following a lengthy introductory process, and all are happy with progress. His observed progress within the home over the past few months bears little resemblance to reports, which mainly concentrate on negative aspects of his behaviour, provided from his previous situation. The manager had compiled her own assessment of his needs and preferences, and history, from discussion with him, his family and professionals, and this profile has provided the basis of his current care plan, which is still subject to change and development. Service users have their own individual contracts; those looked at, including the most recent admission, have been signed by a relative or other representative to indicate agreement. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 8 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 standard(s) 6,7,9 Staff demonstrated a good knowledge of individual needs and preferences. This is supported by individual plans and profiles. Service user decision-making and choice would be helped by the development of simple, clear, individual plans/life books, with, for example, photographs, that service users can more readily relate to. EVIDENCE: Individual care plans are available in the office. These detail individual needs and preferences and are reviewed and updated. Although personal profiles are recorded on a template that is illustrated with simple diagrams, the way the information is recorded is clearly for staff guidance. The manager advised that Person-Centred Plans are now being developed with service users at their day services. Service users were observed making choices and day-to-day decisions. One service user had opted not to go to his day service, which was seen, in this instance, as a positive choice. Service user meeting records showed service users voicing preferences about holiday activities. Discussion showed that these preferences were heeded. Risk assessments for individual activities were seen to be in place.
SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 12,13,15,16,17 Service users have a variety of activities and contacts that they are happy with. Mealtimes continue to demonstrate the relaxed, friendly and co-operative nature of the home. EVIDENCE: Service users attend a variety of day services and have activities that fit in with their needs and wishes. One service user is a keen church goer. Family contacts are maintained and supported, with families visiting, and service users visiting families. Four service users have a holiday coming up, the other two have recently had one. The day services had been closed for the previous two weeks; staff and service users were able to talk of the variety of activities, mostly trips out, that they had taken part in over this period. A meal was taken with the service users. This was a relaxed, enjoyable occasion, with flexibility with in the overall structure of a ‘family type’ meal around a large dining table. One service user chooses to eat away from other service users, preferring quiet while he eats, and this is facilitated by an additional table in the lounge. The food, as on a previous inspection, was freshly prepared, and enjoyed by all. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 10 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 standard(s) 18,19,20 Service users’ personal support needs are met by staff who are familiar with those needs, or who are able to seek advice and support concerning such needs. EVIDENCE: Detailed health records of service users are available. Health screenings of service users by the Community Learning Disability Nurse has recently taken place. Personal support needs are detailed in individual care plans and guidelines. Staff were observed to offer sensitive support and advice. Specialist support and advice is sought, particularly where individual needs are changing/still being assessed. This is most notably the case with the most recent admission to the home. Medication recording, administration, and stock control is satisfactory. Staff all received appropriate training, and ‘blister pack’ administration is used where appropriate. Guidelines are in place and contraindications of medications are highlighted. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 11 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 standard(s) EVIDENCE: These standards were not looked at on this occasion. They will be examined on the next inspection. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 24,25,26,27,28,29,30 Service users live in a homely, comfortable and well-maintained environment. Safety is compromised at present by the fact that all doors identified as requiring alarm activated door closers do not yet have them. EVIDENCE: The small garden area, which suffers from its closeness to a main road and a well-used public footpath, has been renovated and much improved. The large garden area at the back of the house is well-maintained, easily accessible and well-used by service users. The home continues to be well-maintained. The lounge carpet has been replaced; the home is to purchase a new dining room table and chairs to replace the existing ones. Lighting is now brighter throughout. The front doorbell was not working. One service user bedroom was seen. This was attractively decorated, reflecting the service user’s interests. He was keen to point out his pictures and explain them. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 13 The freezer is still in the utility room, although separate from the main area of the laundry, and separated by the kitchen only by a few feet. There was a noticeable build-up of ice in it, although temperatures were satisfactory. Toilets and bathrooms were clean and hygienic, as was the home throughout. Some doors identified as requiring fire alarm activated closures do not yet have them. The manager advised that these are on order. Details of recent safety checks for one service user’s mobility aids were seen. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32,33,34,35,36 Service users are supported by a consistent staff team with whom they are familiar with, and comfortable with, and who are able to meet their needs. EVIDENCE: Staff on duty were knowledgeable and familiar with service users’ wants and needs, and interacted positively with service users. The staff training matrix showed regular training in mandatory and specialist areas having taken place, or, in the case of food hygiene, manual handling, and dementia training, booked in to take place as required. All new staff have completed the Learning Disability Award Framework induction and were moving on to the foundation course, while other staff have achieved various stages of National Vocational Qualifications. Staff records were seen to include satisfactory references, application forms and signed and dated confirmation that satisfactory Criminal Record Bureau checks had been seen, and discussed where necessary. Supervision records show regular supervision taking place; annual appraisals were not available, these are done independently of the manager. Staffing is able to meet the current needs of service users by having two staff on at key times. The manager advised that recruiting staff was not a problem, and that agency staff are never used. Staff advised that the staff team is far more settled of late.
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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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 39 The home is working to ensure that individual service user views are taken into account in the running of the home. At present, this is done most effectively by experienced staff knowing and understanding individual wishes and catering for them. EVIDENCE: Minutes were seen of service user meetings, at which service users are supported to raise issues. On an individual basis, staff showed awareness of which service users were more likely to make their views known, and which service users needed to be encouraged and heeded especially carefully. On a more formal level, the manager advised that the organisation’s ‘My house’ booklets had been completed and were being analysed centrally, and that homes were awaiting feedback. Person Centred Plans are underway for individuals at their respective day services. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23
ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
SCIC - 62 Station Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 x x x x E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 17 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. 1. Standard 23(4) Regulation 24 Requirement The home must complete the provision of alarm-activated doors for those doors identified as needing them. The freezer requires de-frosting. The front door bell requires mending. Timescale for action 9/10/05 2. 3. 16 23 24 24 9/10/05 9/10/05 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 6 30 Good Practice Recommendations It is recommended that the service works on providing, in addition, simple, clear, individual plans that service users can readily relate to. The freezer in the laundry area should be stored in the kitchen, or other more suitable area. SCIC - 62 Station Road E53 S4444 SCIC 62 Station Road V248183 60805 Stage 4.doc Version 1.40 Page 18 Commission for Social Care Inspection 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
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