Inspection on 28/12/06 for Smith Crescent Care Home

This inspection was carried out on 28th December 2006.

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

Smith Crescent Care Home 17/11/08

Smith Crescent Care Home 13/10/05

Smith Crescent Care Home 23/07/05

Smith Crescent Care Home 08/03/05

Smith Crescent Care Home 10/08/04

Smith Crescent Care Home 04/03/04

Similar services:

Hillside

Applegarth

122 Scorer Street

St Marys Nursing Home

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Smith Crescent Care Home 44 Smith Crescent Greenhill Estate Coalville Leicestershire LE67 4JE Lead Inspector Lee West Unannounced Inspection 28th December 2006 16:00p Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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 Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Smith Crescent Care Home Address 44 Smith Crescent Greenhill Estate Coalville Leicestershire LE67 4JE 01530 831767 01530 835046 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) www.leicestershire.gov.uk Leicestershire County Council Social Services Mrs Avril Wilson Mrs Anne Elizabeth Frewin Care Home 6 Category(ies) of Learning disability (6), Physical disability (3), registration, with number Sensory impairment (1) of places Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. No one falling within SI may be admitted into the home when there is 1 person of category SI already accommodated within the home No falling within category SI may be admitted to the home unless that person also falls within category LD ie dual disability No one falling within the category PD may be admitted into the home when there are 3 persons of category PD already accommodated within the home No one falling within category PD may be admitted into the home unless that person also falls within category LD ie dual disability Persons admitted into the home who fall within the category PD may only be accommodated on the ground floor 13th October 2005 Date of last inspection Brief Description of the Service: 44 Smith Crescent is a care home offering respite care and accommodation for six younger adults (under 65 years of age) who have a Learning Disability. The home is also registered for a limited number of spaces for people who, in conjunction with their Learning Disability, have a Physical and/or Sensory Impairment. Smith Crescent has six single bedrooms without ensuite facilities. The home has a rear garden which is well maintained and which is accessible to all service users residing in the home. Owned by Leicestershire County Council Social Services Department and situated close to Coaville town centre, residents have access to shops, pubs, and other amenities, and it is accessible by private or public transport. Accommodation is provided over two floors with access between the floors being via stairs or a passenger lift. Communal areas are provided on the ground floor, with access to the new, spacious, conservatory. Bedrooms are located on both floors. The fees for this establishment are arranged on an individual basis, through the Social Services, and are according to the needs of the service users. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place over three dates, due to no service users being present on the first visit on 1st December 2006. The majority of the inspection took place, again unannounced, over 4 hours on Thursday 28th December, starting at 4.00p.m. and the final part taking place on Thursday 11th January 2007, with a discussion with the registered manager, who was not present on the 28th December. The method used was Case Tracking. This is when a number of service users are spoken with about their experiences and expectations of living at the home. Care plans and other records are analysed, a tour of the premises undertaken, of areas used by the service users case tracked; with staff and visitors views also being sought, to ensure that those living at the home have their needs met and their health and welfare maintained appropriately. What the service does well: What has improved since the last inspection? Specialist overhead tracking hoist has been fitted into one of the bedrooms. Staff training is continuing, some staff have recently achieved National Vocational Qualifications at levels 2 or 3 and others have now been enrolled. Surveys from relatives and service users are audited and used to improve the quality of service provided. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 6 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. The summary of this inspection report can be made available in other formats on request. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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 Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2, 4 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. An in-depth assessment is carried out to ensure individual aspirations and needs can be met. Prospective service users have opportunities arranged to visit before agreeing to respite at Smith Crescent. EVIDENCE: The care plans of three service users were viewed and contained a thorough assessment of needs and of activities undertaken regularly by the service users, to meet their aspirations. Each new prospective service user is given the opportunity to visit the home for a “look round” with their carers for a “tea visit” and then to visit alone to “see how it goes.” The service user’s records reflected this and service users spoken with acknowledged this had happened. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Individual, person centred, care plans are in place and service users are encouraged and supported with their independence to take appropriate risks. EVIDENCE: The plans of three service users accessing the respite services were reviewed. They were detailed, person centred, outlined the specific, individual care needs, how these were to be met and included the wishes and preferences of each service user. Risk assessments and appropriate actions to enable service users to take risks, were seen in the care plans. Service users spoken with said they were happy with the care and enjoyed coming to Smith Crescent for their respite care. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14, 15, 16, 17 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users’ rights are respected and they are able to take part in appropriate leisure and recreational activities within the community as well as in the home. Service users enjoy their meals in pleasant surroundings. EVIDENCE: Smith Crescent offers only respite care, and the service users spend a week, or two, on a regular basis throughout the year. To maintain their personal lifestyle, their plans are linked to those in their usual residence. Maintaining their day centre, educational and other activities throughout their stay. Evidence of this was seen within the care plans and observed when the service users returned to Smith Crescent in the late afternoon. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 11 Service users spoken with responded positively, with smiles, nods and gestures, that they enjoyed their stay at Smith Crescent. Observing the interactions between the staff and service users reflected the positive rapport. Staff welcomed all on their return, ensured they had a drink and discussed what to eat for their evening meals. One service user, who did not verbalise, was able to communicate that a different dessert was wanted. The staff were observed responding to this request with understanding and their knowledge of the service user was demonstrated by their responses and the offering of a favourite dessert. The food looked appetising and was served in a pleasant, well furnished and decorated dining area. One service user, because of behavioural issues, preferred to be alone. This was supported by serving this service user in the pleasant conservatory. The service user was satisfied with this arrangement as the meal was eaten and the service user did not become distressed. This action supported the service user’s dignity and preferences. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Service users physical and emotional health needs are met in a way they prefer and medication is administered appropriately. EVIDENCE: The carers provide personal support consistent with the individual care plans. The service users’ needs are complex and diverse and the care plans include appropriate risk assessments and actions required to safely move and assist them. Staff were observed interacting with the service users in a supportive and approachable way. Staff, when spoken with, were able to demonstrate their knowledge of the service users, their specific assistance required, their preferences and also their emotional needs. Staff explained how one service user liked to spend time outside and what precautions were taken to support this activity, and how distressed the service user gets if this cannot be achieved for any reason. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 13 There were no stocks of medication within the home, as the service users bring their own medication with them. This was recorded and, dependent on the service user’s capabilities, appropriate assistance given to take medication, in accordance with the care plan. The service users, during this inspection, were not able to self medicate and their Medicines Administration Records were signed, medication given appropriately and stored in a locked cupboard. The staff carrying this out have received training in medicines administration, which was recorded in the staff files examined and confirmed by staff when spoken with. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Policies and procedures are in place to protect service users and their views are respected. EVIDENCE: Smith Crescent, as part of Adult Social Care Services, has a robust complaints procedure. There were no complaints about the home recorded. Staff spoken with explained their role in protecting vulnerable adults and how they should deal with any suspicion of abuse. This was in accordance with the home’s policies and procedures and the Department of Health’s Guidance. Staff pointed out that the service users’ protection was important, “because those who use the home for respite care have complex disabilities and are very vulnerable and they can’t all verbalise any problems.” Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27, 28, 29, 30 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. The décor and furnishing of the home are of a good standard and provide a comfortable, safe and hygienic environment. Service users’ bedrooms suit their needs and there is specialist equipment available. EVIDENCE: Smith Crescent provides a homely, comfortable, clean and hygienic environment for the service users. Since the last inspection a large, wooden floored conservatory, has been added. This creates a quiet, comfortable area for service users. During this inspection, a service user, who preferred to be alone, was using it. The décor, in the entire home, was seen to be of a high standard, with up to date wall decorations, as well as comfortable furnishings. Service users were Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 16 observed accessing differing areas of the home and they indicated, by gesture, how they were satisfied with the environment. Personal rooms were furnished to a high standard and there was a ceiling track hoist in one of the bedrooms, with specialist beds in other rooms. The service users had brought in the possessions they wished for their short stay in the home. There were sufficient bathing and showering facilities, also with hoisting equipment, to enable each service user to be assisted appropriately. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 36 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. A competent staff team supports Service users. EVIDENCE: Staff files evidenced the home’s recruitment procedures, with appropriate records, including Criminal Records Bureau checks and references. Staff spoken with said they had training in Learning Disability Award Framework (LDAF). Three staff members had completed National Vocational Qualifications Level 2 and 3, and others were enrolled on Level 2. Mandatory training, which included First Aid, Moving and Handling, Fire Awareness and Food Hygiene, was evidenced in the staff files, with copy certificates and the training matrix was seen to support this. On the day of the visit three members of staff were working, assisting three service users, which enabled them to support the service users’ individual needs. This was observed throughout the visit, as staff and service users interacted. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 18 Staff were observed competently dealing with a service user who had become distressed and couldn’t verbally express what was the problem. After a short time, the service user was calmed and settled. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 41, 42 Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Smith Crescent is a well-run establishment. Service user and relatives views are now taken into account when developing the services. EVIDENCE: The home’s management is open and transparent. Service users and relatives are encouraged to express their views in surveys and questionnaires. These are then collated and audited to maintain the health and safety of service users and to improve the service provided. There is a newsletter, which keeps everyone informed of what is happening. There are also “get togethers” to discover how things could be improved. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 20 There are frequent activities, which involve the local community, as well as the service users, and their relatives, which raise funds for facilities for the service users. The bingo provided funds for a recliner chair, and there are plans for a satellite television system for the service users, who have expressed a wish to have this, and a computer with internet access. The two managers and a deputy maintain the records efficiently and these were seen during the inspection. However, during the visit, staff files were not available as the carers were unsure of how to gain access to them, so a further visit was made to inspect these. If there was an emergency, fire or injury to a staff member, access to these records would be needed urgently. However, during discussions with the manager, the procedures for safekeeping of the keys were explained, with keys being kept at the unit next door. Staff should be reminded of this, to make sure records are available at all times. Health and safety records, maintained by the deputy manager were found to be in order. All the mandatory checks, including fire alarm testing, were regularly recorded and carried out. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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 Standard No Score 1 X 2 3 3 X 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X 2 3 x Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 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. Standard Regulation Requirement 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. Refer to Standard YA41 Good Practice Recommendations Ensure staff are able to access the records kept in the upper office at all times. Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Smith Crescent Care Home DS0000035402.V320514.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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