CARE HOME ADULTS 18-65
SCIC - Stratford Road, 27 27 Stratford Road Shipston On Stour Warwickshire CV36 4AZ Lead Inspector
Kevin Ward Unannounced Inspection 20th December 2005 08:15 SCIC - Stratford Road, 27 DS0000004445.V274007.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 - Stratford Road, 27 DS0000004445.V274007.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 - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service SCIC - Stratford Road, 27 Address 27 Stratford Road Shipston On Stour Warwickshire CV36 4AZ 01608 663129 01789 296724 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 Ms Julia Furniss Care Home 5 Category(ies) of Learning disability (5), Learning disability over registration, with number 65 years of age (2) of places SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 27th July 2005 Brief Description of the Service: 27 Stratford Road is a registered care home for 5 adults who have learning disabilities. Stratford and District Mencap provide 24-hour support and care for the people living in the home. The house is located on a main road close to the town centre of Shipston on Stour where a wide range of community facilities is available. There is a bus service from Oxford to Stratford with a bus stop directly in front of the house. 27 Stratford Road is a detached house built in the 1930s. It has been converted to provide five bedrooms for service users. There are two bedrooms on the ground floor and four bedrooms on the first floor, one of which is for staff doing sleep-in duties. There is also an office and bathroom with toilet on the first floor. There is access to a large loft area but for safety reasons this is not in general use. Shared facilities on the ground floor consist of a dining room, lounge, large kitchen, utility area, a shower room (which is wheelchair accessible), and a separate toilet facility. There are secluded gardens to the rear of the property, with wheelchair access. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection involved looking around parts the home and talking with people at breakfast time before they went out for the day. The inspection also involved meeting with the manager and a group leader and speaking to a number staff during the course of the morning. A sample of service users’ care plans were examined and a number of policies and procedures were looked at during the inspection. The home’s health and safety records were also examined. What the service does well:
27 Stratford Rd provides warm, homely accommodation. At the time of this inspection the home had been nicely decorated to celebrate Christmas and people spoke enthusiastically about the party they had enjoyed the night before. The people living at the home have lived together for several years and all take part in everyday living chores, providing a positive contribution to the life of the home. Comments made by service users confirmed that they are very happy living at the home and enjoy the company of the staff that support them. Staff were seen to treat people in a friendly, caring manner and service users appeared very comfortable and relaxed in the company of staff. The people living at the home confirmed that they are supported to venture out into the local community with support from staff and to take holidays away from the home. Service users had recently returned from a weeks break at Bourton on the water, whilst a new central heating system was installed in the home. The people living at the home appeared to take pride in their home and were seen to take part in daily living tasks about the home. On the morning of the inspection people were seen to carry out light domestic chores, such as wiping down services, loading the dishwasher and moping the floor. Since the last inspection the home has completed a consultation exercise with people and the findings have been summarised so that the outcomes are clear. An action plan was seen for addressing issues that have arisen from the consultation. Regular monthly meetings are also in place for people for people to raise concerns and to be consulted over issues in the home. Entries in the meeting log demonstrated that people had been informed over plans for the central heating system to be installed. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 6 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 - Stratford Road, 27 DS0000004445.V274007.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 - Stratford Road, 27 DS0000004445.V274007.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): 5 The home issues people with contracts, in an accessible format, so that they are made aware of their rights and responsibilities at the home. EVIDENCE: There have been no changes to the group of people living at the home since the last inspection, 27/7/05. Contracts have been issued to everyone living at the home in an illustrated format, to aid people’s understanding where this is necessary. The contracts have recently been revised to include the details of any additional charges, over and above the general fees, that service users are required to fund, e.g. transport charges. SCIC - Stratford Road, 27 DS0000004445.V274007.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 and 8 The home regularly reviews people’s needs, with their involvement, so that they are kept aware and can contribute to their personal plans. The home consults with people and provides opportunities for them to voice their views about the home, so that they are able to exercise some control over life at the home. EVIDENCE: Care plans are in place for all the people living in the home. A sample inspection of service users care plans confirmed that good levels of information have been developed to support staff to deliver sensitive care to people. The care plans are helpfully cross-referenced with health plans and risk assessments so that these matters are considered properly by staff when supporting people with their care. In some cases positive work has taken place to develop health plans in a more accessible format using illustrations. Care plans were seen to be dated to confirm they have been reviewed and where necessary amended. Service users signatures were seen on their care plans as confirmation that this information has been shared with them. Service users’ care plans were reviewed last year, with the involvement of social workers and
SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 10 the manager explained that she is approaching Social Services to repeat this process again this year. The people living at the home were seen to take part in light chores, such as cleaning and tidying the home and appeared to take pride in their living environment. Comments made by the people living at the home confirmed that they receive support to go shopping to choose their clothes and personal items. Service users’ meeting records demonstrate that people meet together each month to discuss plans and to comment on life at the home. One person confirmed that she has been involved in representing service users at recent staff interviews at the home. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 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): 13 The home supports people to find employment and leisure activities that meet their needs so that their time is filled purposefully and they take part in the life of the community. EVIDENCE: Several people living at the home attend day services during the week. Additional staff support is provided for one person with high needs to stay at home during the week and venture out each day. Similarly one person also receives separate support three days a week. On the day of the inspection the two people concerned were supported to go shopping and have lunch out. One person explained that she has a busy part-time job at supermarket that she enjoys several days a week. People spoke very enthusiastically about a Christmas party that had taken place at the home on the night prior to this inspection, which included visits by friends and relatives. Comments made by service users and staff indicate that people are supported to enjoy access to reasonable level of social activities. Common examples included, walks, shopping, cinema, theatre, pub for drink or meal. Service users also spoke positively about a recent weeks holiday break at Bourton on the water, funded by the home, whilst central heating was being fitted.
SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 12 SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 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): 19 The home supports people to receive access to support from health professional and to make use of community health services so that their health needs are properly addressed. EVIDENCE: All service users have a well-organised file containing their health records. A sample examination of health records indicates that good work takes place to support people to gain access to support from health professionals and to monitor people’s health needs. Similarly the records provide evidence to confirm that people are supported to gain access to make use of local community health services for routine heat checks, such as, well person checks, dentist optician etc. Excellent health plans were seen to be in place for one person with high level health needs, including accessible versions to assist her to understand the support that was available for her at the home. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These Standards were not assessed on this occasion. EVIDENCE: SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 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 Overall the home is well maintained and furnished so that people are provided with a clean, comfortable and homely environment to live in. EVIDENCE: The main communal areas of the home were inspected on this occasion. Since the last inspection work has been carried out to install a new central heating system in preparation for winter. At the time of the inspection a bathroom was being refurbished upstairs to improve these facilities for people. A second wellequipped bathroom is also available to people to use downstairs in the home. Attractive new radiator covers have been fitted throughout the home since the last inspection, to remove any risks of people being scalded. The home is furnished comfortably and the manager confirmed that plans are in place for some areas to be redecorated. Comments made by service users confirmed that they are involved in choosing paint colours for the home. The carpets in the communal areas are showing some signs of wear and should be replaced in the coming year. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 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): These core Standards were assessed as met at the last inspection and were not inspected on this occasion. EVIDENCE: SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 39 and 42 Systems are in place for consulting with people so that their views influence the work of the home. Overall the home has good health and safety procedures and risk assessments in place to protect people from harm. The addition of a hot water risk assessment would confirm that people are not at risk of being scalded. EVIDENCE: Since the last inspection good work has taken place to interview everyone living at the home to seek their views about the service. A helpful summary report of the findings of the consultation were seen with action points for managers to follow up issues raised by people. The manager explained that plans are in place to revise some of the questions on the questionnaire so that they are more easily understood next year. As previously noted service users’ meetings are routinely taking place at he home. Entries in the meeting log show that people are given regular opportunities to pass comment on the service or raise any concerns. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 18 A new boiler has been fitted in the home and hot water temperatures are being recorded and monitored. These records show that the hot water temperature is over 43 degrees C. The manager explained that new regulator valves are being fitted to the bath and shower. The manager said that she believes that it is not necessary to fit valves in people’s bedrooms and agreed to complete a risk assessment for each person to how to confirm that this is the case. Fire safety records confirm that fire alarms and lights are being routinely tested as required. An examination of the home’s maintenance records and certificates confirmed that gas and electrical appliances are being appropriately maintained. A good range of environmental risk assessments were seen to be in place to safeguard the people living at the home. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 19 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 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 x 23 x ENVIRONMENT Standard No Score 24 3 25 x 26 x 27 x 28 x 29 x 30 x STAFFING Standard No Score 31 x 32 x 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 3 x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 x 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 x x x x 3 x x 2 3 SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 20 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 YA42 Regulation 13 (2) (c) Requirement Carry out a written risk assessment to determine the need for hot water regulator valves in people’s bedrooms. Timescale for action 14/01/06 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 24 Good Practice Recommendations Make plans to upgrade the carpets in the communal areas during the coming year. SCIC - Stratford Road, 27 DS0000004445.V274007.R01.S.doc Version 5.1 Page 21 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
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