Inspection on 12/08/05 for 85 Park Road

This inspection was carried out on 12th August 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

85 Park Road 29/01/07

85 Park Road 02/02/06

85 Park Road 11/11/04

85 Park Road 25/06/04

Similar services:

SignHealth

Mere Hall View

Beechfield Lodge

Christopher Grange (Rhona House)

Auden House

Deafway

Sign, 100 Bowfell Road

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

CARE HOME ADULTS 18-65 Sense 85 Park Road Accrington Lancs BB5 1ST Lead Inspector Keren Nicholls Unannounced 12 August 2005 12.10 am 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. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Sense Address 85 Park Road Accrington Lancs BB5 1ST 01254 397937 01254 397274 debbie.bond@sense.org.uk Sense North www.sense.org.uk Mrs Deborah Marie Bond Care Home 5 Sensory Impairment 5 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) Category(ies) of SI registration, with number of places Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th November 2004 Brief Description of the Service: 85 Park Road provides accommodation and personal care for 5 younger adults (aged 18 to 65 years) with sensory impairment, physical disabilities and learning disabilities. The home is part of the larger organisation of Sense, which is the largest specialist voluntary organisation in the United Kingdom working with people with deaf blindness and associated disabilities. 85 Park Road is a detached purpose built house, located in a residential area of Accrington. It is opposite a school and within walking distance of shops, a public house and a park. There are good public transport links nearby and the home provides mini-bus transport for service users. There is a lounge, a smaller quiet room, a dining room, kitchen and laundry on the ground floor. There are single en-suite bedrooms on the ground and first floor. The first floor is accessed by a staircase. Outside is a pleasant side garden with outdoor seating and parking for four cars at the front. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit took place over one day, when a total of 4.05 hours were spent on the premises. During this time the inspector spent time with four of the five people who live at the home, examined written information including records and looked around the communal areas. The inspector talked to the manager of the home and the staff and briefly to one person’s relative. Since the last inspection, an introductory visit had been made to the home, when one service user had invited the inspector to look at a bedroom. What the service does well: What has improved since the last inspection? The manager had carried out all the requirements and all bar one recommendation from the last inspection. These have helped minimise risk to service users and safeguard their rights and included: Amending the statement of purpose and contract/terms and conditions of residence; ensuring staff received medication administration training; providing cold storage for medicines; evidencing robust recruitment procedures; ensuring that staff are always identifiable to service users. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 6 Daily lifestyle improvements for service users had been achieved. For example, planned additional structured routines and activities made sure service users had interesting and enjoyable days with choice and independence and opportunities to learn new skills, such as baking and food shopping. Improvements had continued at the premises that suited individual’s needs and choices, such as new bedding, beds, and bedroom decoration and a lighting system in one person’s room. 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. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 1, 2, 3, 4 and 5 Service users and their representatives had visited, been consulted about needs and wishes prior to admission and given written information about the home. This enabled service users to make an informed decision about whether Park Road was the right place for them to live. Trained people had helped to assess needs, to ensure that these could be met by the home. Contracts had been made between the home and each service user via their representative, to ensure that both parties’ rights and responsibilities were protected. EVIDENCE: The ‘service user’s guide’ and ‘Statement of Purpose’, which explained the aims and objectives of the home and relevant information about complaints, the premises and staff team, had been given to service user’s representatives. Current service users were unable to comprehend written language, or most sign and symbol but their representatives and the home’s staff had made every effort to ensure that each person understood the information and their rights as laid out in formal terms and conditions of residence. Comprehensive assessments of need, which included needs and wishes identified by service users and their relatives had been made by the manager and referring social workers. The admission process for everyone had been unhurried and carefully planned, with introductory and trial periods. The staff had appropriate training to ensure that they could properly meet each person’s needs through a detailed care plan. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 6, 7, 8, 9 and 10 Care plans were exceptionally well documented and reflected each person’s needs and preferred way of life. The arrangements to regularly review care plans with service users and their representatives were good. Service users participated in many aspects of life at the home and were enabled to take responsible risks. Staff supported everyone to be independent. Confidentiality was understood within a risk assessment framework and was respected by staff. EVIDENCE: Each person’s care plan reflected the complexity of his or her needs and detailed how these were to be met. Aims for care, including communication strategies were explicit, as were any limitations, risk assessment and the reasoning behind this. Service user’s views and best interests were at the heart of their plan and the plan was updated regularly with all the people concerned with the person’s care. The home adopted a ‘person centred’ approach, which helped to gain insight into the needs of service users. This supported their wellbeing and happiness by ensuring positive experiences, promoting independence and reducing problems. Service users made their own decisions about where to be and what to do in their home. Although spoken communication was difficult, service Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 10 users and staff were skilled at using body language and individual communication strategies to ensure needs and wishes were met promptly. Support was given within a risk-assessed framework, in order for people to be safe and feel confident, for example when going out or away on holiday. Staff respected confidentiality within the boundaries of the home’s policy. Files and other confidential information was kept locked away safely and securely and staff were careful to respect confidentiality when talking about service users, so service users can be sure that their privacy and dignity is respected. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 11, 12, 13, 14, 15, 16 and 17 The home had created a supportive environment for service users to lead fulfilling lives, and participate in appropriate leisure and social activities of each person’s choosing. Staff respected everyone’s rights and helped service users with personal development, community and family links and social inclusion. The home promoted healthy eating and staff supported service users with cooking skills. EVIDENCE: Service users and staff worked together to improve practical skills such as cooking, shopping and household chores and service user choice was positively promoted. Staff explained how service users made food-shopping choices and how individual choice and ‘healthy eating’ was promoted in flexible menu planning. Service users enjoyed their meals and used the kitchen when they wished for drinks and snacks. One person took pleasure in baking with a staff member in the afternoon of the inspection. Staff said that visitors were made welcome and they encouraged and enabled service users to keep in touch with family and friends. One service user was busy getting ready to stay with family for the weekend. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 12 Disability was not seen as a barrier and service users enjoyed a variety of individual hobbies and interests. These included a regular craft competition at the home, going shopping, horse riding, swimming, to the pub, church and cinema, beauty treatments, keep fit, walks, day trips and holidays at home and abroad. College courses were also available. Public transport is used to get out and about, or the home has a mini bus. Records showed that staff supported service users in something of their choosing every day. On the day of inspection, several service users were keen to go out to a local pub. Service users and staff were also busy planning holidays. Within the house, service users had privacy in their own bedrooms if they wanted, with a flashing doorbell to gain attention. Daily routines were flexible and each person’s communication interpretations were known and their decisions respected by staff. Restrictions on lifestyle choices were minimal, were noted as part of each person’s care plan as part of a formal risk assessment and understood as being in their best interests. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 Personal and healthcare support was provided in a flexible and individual manner, which respected service users’ privacy, dignity and independence. There were good systems for safe administration of medicines. EVIDENCE: Staff ensured that service user choices about personal routines, such as getting up/going to bed times, bathing, clothes choice, going out etc. were respected. Personal care needs were recorded in care plans and staff help was given sensitively and discreetly. Each person had a detailed routine plan and record, to ensure care continuity. Healthcare needs were closely monitored by staff observation and service user behaviours. GP, outpatient and other medical check visits were planned and recorded and service users supported to attend clinics. Appropriate professionals oversaw specialist needs and each person had assessed aids for living and mobility. There were safe medication storage, recording and administration policies and procedures, which were followed by staff who had accredited training. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Complaints were taken seriously and 85 Park Road had a robust complaints procedure, which was followed. This ensured that complaints were acted upon within reasonable timescales and service users and their representatives could be confident that their concerns, no matter how ‘minor’ were listened to and properly investigated. Procedures were in place to respond quickly to suspicion or evidence of abuse. Trained staff had a good understanding of how to protect residents and to respond appropriately to allegations of abuse. EVIDENCE: There was a detailed complaints procedure in the service user guide and policies file, which staff had signed to indicate their understanding. Throughout the inspection service users indicated their feelings and requests, which were listened to and acted upon by staff. There had been no complaints since the last inspection and a visiting relative had no complaints or concerns about the home at present. The home had an adult protection procedure and a copy of “No Secrets in Lancashire”. These documents were available to staff and set out the response should there be any allegations or evidence of abusive practice. Staff said they had received training in protecting the residents and through discussion showed they had a good understanding of the procedure and the action they should take. Further policies and procedures regarding service users financial affairs and challenging behaviour were adhered to. The manager had followed procedure in respect of referring staff who may be unsuitable to work with vulnerable adults, for consideration for inclusion on the Protection of Vulnerable Adults register. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 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 standard(s) 24, 27, 28, 29 and 30 The house was non-institutional and suitable for its stated purpose of supporting younger adults who have a sensory impairment. The premises were comfortable and had a good standard of décor, maintenance and cleanliness. EVIDENCE: The house is spacious, near to local transport, shops and other amenities and is in keeping with other properties in the locality. The furniture, fittings and decoration were domestic in style and of acceptable quality. The property was necessarily clutter-free, but service user’s personal belongings and pictures gave the house a more ‘homely’ feel. The home had been designed for people with sight and hearing loss, with aids and adaptations to enable independence. For example the stairs were fitted with grab rails and colour contrasts, there was a pull cord alarm system, loop system in the lounge, text phone, minicom and alarm to the front door. Doorbells with lights were fitted to all bedrooms. Wide doorways had ‘objects of reference’ nearby, to enable recognition of the purpose of the room (e.g. knives and forks and spoon to denote the kitchen and dining room). Raised and textured letters were fitted to some doors to allow tactile identification. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 16 Likewise, staff wore different bracelets as objects of reference, so service users could easily identify the wearer. Service users were enabled and encouraged to use the kitchen and laundry, which had appropriate recognition aids and equipment. Outside was a tidy accessible garden, with seating. One service user had a swing seat. The home had plans for improving the premises for service users: The manager and staff explained that everyone was working hard to raise funds for a conservatory. Further equipment for the sensory room was also on the fund raising agenda and it was suggested that this should be progressed as soon as possible. Although the carpets were regularly professionally cleaned, there was a slight odour in the lounge. The manager said that the carpet was soon to be replaced and new furniture for this room was planned. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 17 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) 31, 32, 33, 34, 35 and 36 Robust recruitment policies and procedures were followed when appointing staff. This resulted in a workforce that had been properly vetted and care workers who were suitable to work with vulnerable adults. Staff supported the aims of the home and had undertaken in-service and NVQ level 2 training in order to meet the individual needs of residents. Residents’ personal development was promoted and protected by a good programme of staff supervision and appraisal. Staff morale was high and staff motivated and enthusiastic, resulting in a team committed to improving residents’ quality of life. EVIDENCE: ‘Case tracking’ of staff files, records and other documents and discussion with staff showed that full and satisfactory information was obtained prior to staff appointment (such as identity checks, references and Criminal Records Bureau checks). Staff files were well kept with interview notes, records of training and qualification. Staff members had a pleasant manner and relaxed and friendly relationships were enjoyed between service users and staff. The manager was confident that the staff team understood the fluctuating needs of service users and gave appropriate support. Staff had good knowledge of care plans and their role in supporting service users and explained how such matters were discussed in Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 18 their regular supervision sessions with senior staff and at staff meetings. Service users indicated by their actions and interactions with staff that they liked and got on well with staff. Several new staff had been appointed, who had been given appropriate induction and foundation. Everyone said that the staff training was “excellent”. Staff said that there had been recent certificated training in medicines administration, health and safety matters, protection of vulnerable adults and care practices relating to the special needs of deaf blind people. Over half the staff team (60 ) had completed NVQ level 2 training and eight were undertaking level 3. Staff related well to service users’ personal interests. Sufficient numbers of staff were on duty to meet everyone’s needs and the staff team mix reflected the service user population in respect of age, gender and cultural background. Although staff had been given copies of the General Social Care Council codes of conduct, they were uncertain about the content. It was recommended that staff should familiarise themselves with these and how compliance with the codes should improve the lives of service users. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 19 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 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) 37, 38, 40 and 41 A qualified and experienced registered manager, who ensured that the home was run in the best interests of the service users and who provided appropriate leadership for the staff team, was in charge of 85 Park Road. Sound and comprehensive policies and procedures underpinned care and health and safety practices, ensuring that risks to service users were minimised. Systems that encouraged and enabled everyone involved with the home to express their views and opinions were in place. EVIDENCE: A clear management structure was in place to support care workers. Staff said they were very happy with the competence of and support from the management team. The registered manager provided effective leadership and ensured that there was ‘hands on’ oversight of the care team so that the needs of service users were properly met. Staff said that everyone worked well together as a team and shared all jobs, although as a new team who had experienced recent change and difficulty, they would like to be involved in some team building exercises. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 20 Service users found it difficult to be involved in the running of the home, but were able to make their views and opinions known through their individual ways of communicating. Throughout the inspection, service users confirmed in different ways that they were happy with the service, the home and the staff. Service users relatives also acted as advocates in influencing change and securing improvements and their involvement was recorded. Staff said they had opportunities to affect the way in which the home was run through staff meetings and supervision. The manager and staff demonstrated enthusiasm for improvement. Staff thought that a suggestion box would be another strategy for effecting change. Several staff said they missed the input from the manager when she was away from the home at meetings or other events, (although a senior staff member was always left in charge). It may be helpful for the manager to explain how these meetings influence the running of the home, and as far as possible involve the staff and service users in external management strategies. Records required for the protection of service users and to safeguard their rights were well maintained and up to date. The home had clear sets of policies and procedures, which were freely available. Relevant policies were given to service users representatives (e.g. the complaints procedure, health and safety matters etc.) and explained to service users through sign, symbol, hand over hand, touch or smell etc. Service users’ personal records described and explained how the home acted in the best interests of the individual. Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 21 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 3 3 3 Standard No 11 12 13 14 15 16 17 4 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 2 4 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Sense Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 2 x 3 3 x x F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 22 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 Regulation Requirement There were no requirements from this inspection Timescale for action 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 31 38 Good Practice Recommendations The manager should ensure that staff are familiar with the GSCC codes of conduct, and how compliance with these codes improves the lives of service users (31.5) That the manager explains how the meetings she is involved with affect the running of the home (38.4) and that the suggestions box is used to encourage innovation, creativity, development and change (38.5) This recommendation carried forward from the last inspection: The current method of recording marks and bruises found with the cause unknown should be reviewed to allow for more thorough recording to take place. 3. 42 Sense F57 F07 S38926 Sense V244450 120805 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Unit 4 Petre Road Clayton-le-Moors Accrington BB5 5JB 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. 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