CARE HOME ADULTS 18-65
SCIC - Stratford Road, 29 29 Stratford Road Shipston On Stour Warwickshire CV36 4AZ Lead Inspector
Kevin Ward Unannounced Inspection 20th December 2005 08:15 SCIC - Stratford Road, 29 DS0000004491.V274045.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, 29 DS0000004491.V274045.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, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service SCIC - Stratford Road, 29 Address 29 Stratford Road Shipston On Stour Warwickshire CV36 4AZ 01789 298709 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 3 Category(ies) of Learning disability (3), Physical disability (0) registration, with number of places SCIC - Stratford Road, 29 DS0000004491.V274045.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: The home provides respite care in a bungalow with three single bedrooms, a shower, two toilet rooms, a kitchen/diner, lounge, staff sleeping in room/office and a garden. It was built in the 1930s on what is now a busy road through the village. The service provides opportunities for adults with a learning disability to develop life and social skills and some degree of self-management. The bungalow stands on the same plot as another care home run by the same organisation for five residents and shares the same manager, staff group and semi circular drive. SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was time limited and focused mainly on reviewing the requirements of the last inspection and assessing a number of core Standards that were not previously assessed. 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 member of staff, on duty on the morning of the inspection. A sample of service users’ care plans were examined and a number of policies and procedures were looked at during the inspection. What the service does well: What has improved since the last inspection? What they could do better:
Overall the home is well maintained and in good condition. However the kitchen cupboards are rather old and would benefit from refurbishment. The Chief Executive has outlined proposals to address this along with some other modifications to the home during the next year.
SCIC - Stratford Road, 29 DS0000004491.V274045.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 - Stratford Road, 29 DS0000004491.V274045.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, 29 DS0000004491.V274045.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 provides people with contracts in order that they are made aware of the service they may expect when they visit the home and so that they are informed of their rights and entitlements. EVIDENCE: Service users have been provided with contracts by the Social Services Department and examples of these documents are kept on file. The home also provides people with a contract of terms and conditions so that they are clear about the service they are paying for and any extra costs that they may need to fund during their stays at the home. Comments made a by service users present at the inspection indicate that the contents of the contract were also explained to them when they were issued. SCIC - Stratford Road, 29 DS0000004491.V274045.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 7 Care plans are agreed and reviewed with the involvement of service users so that their needs are properly planned for and met during their stays at the home. The greater involvement of social workers and carers will be of benefit when reviewing people’s needs. Staff support people to make choices and take part in daily living tasks so that they maintain and develop their independence when they stay at the home. EVIDENCE: A sample of service users’ care plan files were examined. These documents are fairly brief but contain the essential levels of information necessary to enable staff to support people during their respite stays at the home. Information contained in these files included details of their personal care requirements and health needs, in addition to a personal profile, summarising people’s routines and their likes and dislikes. The home has started to write more comprehensive overviews of individual’s needs, which are being added to their files. The file of a service user with high healthcare needs was examined. Information contained in the file and comments made by the manager confirmed that the home seeks regular updated information to appropriately
SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 10 support the person concerned. Care plans are currently being reviewed and updated by staff at the home. The manager explained that there are plans in place to develop a new review process to increase the involvement of social workers and carers where this is appropriate. Comments made by service users and a member of staff on the morning of the inspection confirmed that people are encouraged to take part in light domestic chores whilst they are staying at the home to encourage their independence, e.g. make beds, set tables, make packed lunches and take part in some cooking. The main grocery shopping is carried out by staff, based on service users’ recorded food preferences, so that they are provided with food that they enjoy when they visit. SCIC - Stratford Road, 29 DS0000004491.V274045.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): 16 Staff at the home encourage people to take responsibility for developing their personal independence and respect their rights and privacy. EVIDENCE: Comments made by service user at the home on the morning of the inspection indicate that they find staff to be friendly and respectful towards them and to show a proper regard for their privacy, e.g. knock and wait before entering their rooms. Bedroom doors are fitted with safety locks so that people can get out of their bedrooms easily without having to use a key. As previously noted service users care plans includes details of daily living tasks that service users carry out at the home, to develop their independence. SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 12 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Procedures and risk assessments are in place to support people to manage the administration of medication in a safe manner and to meet their health needs when they stay at the home. EVIDENCE: The home does not offer a service to people with complex health needs and high support needs. Consequently none of the people using the service receive visits from community nursing services and there is no need for any health protocols to be in place at the home, e.g. administration of diazepam. Service users with minor health issues are able to use the service and receive support from staff to maintain good health e.g. dietary advice to manage diabetes. One person using the service has been diagnosed with a serious health condition. Entries in this person’s file and comments by the manager confirmed that the home gets regular updates and relevant information from her normal support staff in order that appropriate support is provided to the person concerned when she stays at the home. As the home provides a respite service, rather than permanent care, health monitoring remains the responsibility of service users themselves, with support from their relatives, carers or support staff. Since the last inspection positive work has taken place to increase the information contained in the risk assessment of a service user who manages her own medication whilst she visits the home. This enables staff to be clearer
SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 13 about their responsibilities in this matter and for monitoring medication. A sample examination of service users’ medication records indicates that medication is being appropriately signed for by staff. Arrangements are in place for checking medication into and out of the home and for safely accounting for any controlled drugs that are used. A separate bound record, signed by two staff, is in place at the home for this purpose. SCIC - Stratford Road, 29 DS0000004491.V274045.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 core Standards were assessed as met at the last inspection and were not inspected on this occasion. EVIDENCE: SCIC - Stratford Road, 29 DS0000004491.V274045.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): Overall the home is comfortably furnished and well maintained so that people have clean and comfortable environment to live in whilst they are on respite visits. EVIDENCE: 29 Stratford Rd provides ground floor bungalow accommodation for three people. Access throughout the home is even, making it suitable for people with mobility problems. There is also a good-sized walk in shower room, which is suitable for people with disabilities. However the design of the home and the limited size of some rooms means that the home is not suited to meet the needs of wheelchair users. The kitchen units are rather old and would benefit from refurbishment. Since the inspection the Chief Executive explained outline plans to modify the bungalow in the coming year, which would include improvements to the kitchen area. The lounge area is comfortable and cosy with sufficient seating in place for people to sit down together if they wish to do so. The bedrooms are adequately sized and equipped to meet the needs of the people that the home is set up to support. SCIC - Stratford Road, 29 DS0000004491.V274045.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, 27/7/05 and were not inspected on this occasion. EVIDENCE: SCIC - Stratford Road, 29 DS0000004491.V274045.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): These Standards were not assessed at this inspection. EVIDENCE: SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 18 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 2 3 x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 3 3 x x x x x x x x SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 19 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 YA6 Regulation 15 (2) (c) Requirement Proceed with plans to increase the involvement of relatives and social workers in reviewing people’s care plans. Timescale for action 28/02/06 SCIC - Stratford Road, 29 DS0000004491.V274045.R01.S.doc Version 5.1 Page 20 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 Firm up plans to refurbish the kitchen. SCIC - Stratford Road, 29 DS0000004491.V274045.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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