Inspection on 18/07/05 for St Albans Close

This inspection was carried out on 18th July 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

St Albans Close 17/07/06

St Albans Close 28/02/06

St Albans Close 21/01/05

St Albans Close 27/05/04

St Albans Close 02/03/04

St Albans Close 22/01/03

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

CARE HOME ADULTS 18-65 St Albans Close 1-2 St Albans Close Northampton Northants NN3 2RJ Lead Inspector Sheila Smith Unannounced 18 July 2005 @ 16:30 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. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service St Albans Close Address 1-2 St Albans Close Northampton Northants NN3 2RJ 01604 785775 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) Royal Mencap Society Vacant Care Home Only 7 Category(ies) of Learning Disability (LD) 7 registration, with number of places St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: There are no additional condition of registration. Date of last inspection 21/01/2005 Brief Description of the Service: St Alban’s Close is a residential care home providing personal care and support to 7 men with learning disabilities; a service provided by the national charity Mencap. It is situated on a residential estate on the outskirts of Northampton Town Centre with access to a range of community facilities. The Home comprises two semi-detached properties, which have been merged, and undergone major refurbishment to create a spacious and homely environment suited to the needs of the service users. Gardens to the rear of the house have been landscaped and provide spacious outdoor facilities. Most service users attend day activities away from the Home and there is no designated work or training focussed occupational facilities at the Home. All nursing and health care needs are met by external health care services.A small self-contained flat has been created on the first floor and is occupied by one of the service users who has a high level of independence and self-skills. Staff provide support and supervision as needed, the service user concerned is able to access all other facilities and services of the Home on an equal basis. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Residents, and upon their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 2 residents and tracking the care they receive through review of their records, discussions with them, and with the care staff, and observations of care practices. The inspection took place during an evening over a period of 4 hours and was carried out on an unannounced basis. Communal areas, and some bedrooms were visited. A selection of care records, and essential records of the home were reviewed. A number of the residents were spoken to as part of the inspection process. A Registered Manager from another home, who was not on duty during the inspection, is currently managing the home. The Commission had received a number of comment cards from residents and relatives prior to the inspection. In the main the comments recorded were positive and praised the home and the staff for the way in which the care is provided. What the service does well: This small home provides a family style environment, which the service users, who have lived together for some time, said they like. Staff supervise and assist service users with household tasks according to their individual abilities. Residents choose what activities they wish to participate in, and are able to go on holiday. The home was decorated to a high standard and the residents’ bedrooms that were inspected were personalised containing, personal items, and decorated in colour schemes chosen by the service users.Each bedroom has its own ensuite facility. A downstairs bedroom and bathroom can accommodate a wheelchair user if required. A small flat within the home accommodates one St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 6 service user who lives independently with minimum support from staff in the home. Residents have appetising and healthy food. On the day of the inspection the evening meal consisted of Pork chops, vegetables, mashed potatoes, followed by fresh fruit or gateaux. The previous evening a barbeque had been arranged which the residents had enjoyed. The individual care plans had been written by the service users and gave clear instructions to the staff about the kind of help that they required to meet their goals. The staff rota was displayed on a notice board, and had photographs of the staff against the times they were on duty throughout the week, so that service users were able to look for themselves who was on duty. Fresh cold water from a machine was available for the service users and staff. What has improved since the last inspection? What they could do better: The daily records should be a ‘pen picture ‘ of the service users life in the home. Currently the daily records are not completed every day. The home has an activity record, which should be completed following every activity in which the service user has taken part. This record is not kept up to date; consequently there is no evidence that the activity plan drawn up for each service user is being followed. Staff training could be improved to include specialist training to cover the needs of the service users living in the home. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 7 . The stock control of medication could be improved to ensure that medication not used on a regular basis is accounted for. 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. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 8 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 St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 9 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 and 5. The assessment process was thorough and holistic, and individual needs and desires had been assessed and recorded, so that each service user is assured that the home can continue meet their individual needs. EVIDENCE: A statement of Purpose and a Service User Guide have been developed; some minor additions are required to fully meet the regulations. There have been no new service users admitted for some considerable time. The contents of the current service users files provided evidence that staff had carried out a changing skills assessment recently, which indicated areas where the service user had improved or deteriorated and, detailed the actions required by staff to assist service users reach their goals. There was evidence that other professionals had been contacted to contribute their assessments to the process. A contract was in place for one of the service users, this agreement clearly set out the terms and conditions of occupancy, and had been signed by the service user. A contract was not in place in the second file observed. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 10 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 and 9 Service Users rights are respected and they are encouraged to be involved in, and make informed decisions about their own lives with the support and assistance of the staff. EVIDENCE: Staff at the home have developed the care planning process since the last inspection and the service users case tracked had a plan of care, which reflected their needs. The plans were written in the first person showing evidence of the involvement of the service user. The care plans inspected were clear and comprehensive and had been written in recently. Each service user has a key worker. Service users spoken to indicated that they made their own decisions and choices, based on information given to them by the staff and displayed on the notice boards. One service user said ‘ I enjoy weekends because I can choose to have a lie in ‘ another said that he liked to choose sausages for his evening meal One of the service users is in paid work and manages his own finances, choosing how much to spend and how much to save. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 11 Case records evidenced that risk assessments are undertaken to a good degree and strategies of management were in place to eliminate or minimise risk, including behavioural management strategies. Service users comments and the Inspector’s observations evidenced that staff provide support, guidance and training to assist them to manage their own personal safety. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 12 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. Service users are given support to improve their independence skills within the home, and are given opportunities to integrate into the life of the community. EVIDENCE: Staff and service users confirmed that they had opportunities to increase their practical life skills and were encouraged to do things for themselves, and to help with household tasks such as helping to keep their bedrooms clean, setting and clearing tables washing up, and assisting with their own laundry. On the evening of the inspection one service user was preparing his lunch box for the following day assisted by a member of staff. Each service user has a daily activity plan. Four service users have individual arrangements to attend day-centres. One service user has a full-time work placement, which he has attended for some time, and another has attended a music course at a local college. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 13 Two of the service users spend much of their time with the staff in the home. It was unclear from records exactly what opportunities were offered to these service users, to access the community, as contact sheets are not completed every day, but staff said that they participated in trips to the park, shopping, and going to the pub. All of the service users attend discos, bowling,and going out to a restaurant for a meal. A recent visit to Hollowell steam fair had been thoroughly enjoyed. Three of the service users had been on holiday this year to Euro Disney, and one user enthusiastically said ‘ I look forward to my holidays.’ Service users are enabled to maintain links with family and friends. There is an open house policy, and visitors are made very welcome at the home, or arrangements are made for service users to visit their relatives. Service users can receive visitors in the privacy of their own rooms if they wish. Observations made during the inspection, and service users comments confirmed that daily routines were flexible and in accordance with users wishes. Service users confirmed they had choice and freedom of movement within the House, choosing where they wished to spend their time and whether or not they wished to take part in activities. One Service user said ‘ I enjoy weekends so that I can have a lie in’ Service users are offered a well-balanced diet and take part in the menu planning, and it was observed, during the inspection and confirmed by the service users that there was regular access to food and drink. A cold waterdrinking machine had been installed. The menu on the night of the inspection consisted of Pork chops, mashed potatoes, vegetables, followed by fresh fruit and gateaux. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 14 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) 19 and 20 The arrangements for planning care in this home are good ensuring that health personal and social care needs of people living in the home are fully met EVIDENCE: There was evidence within the files that other professionals were involved with health care needs, for example records of General Practitioner visits. Chiropodist, Dentist and Optician appointments are arranged on a regular basis. Staff said that the service users received good support from the local Health Care Centre. All staff administering medication have received medication training. The Home has a contracted Pharmacist and a pre-packed blister system is used. There is an incoming medication record with medication checked by staff. A medication disposal record is maintained and signed by the receiving pharmacist. Advice given at the last inspection regarding the stock control of paracetamol has not been actioned, and consequently the amount of paracetamol kept in the cupboard is unknown. (This is the subject of a requirement) One of the service users has been assessed as able to administer his own medication, and signs to accept his months supply of medication. Medication was stored appropriately. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards will be inspected at the next inspection. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25 and 30 The environment provides safe comfortable surroundings and is maintained to a high standard. EVIDENCE: The areas viewed on this inspection were well decorated and furnished to a good standard. General hygiene and domestic maintenance was good. The home is close to local amenities and is in keeping with the surrounding residential area. All of the service users have single bedrooms with en-suite facilities, and all rooms were pleasantly decorated, light, cheerful and well maintained. Service Users were anxious to show their personal possessions, and said that they had chosen the colours for their rooms. Although the home has no current need, the downstairs bedroom and en-suite facilities are accessible for wheelchair users. A large bathroom is also available downstairs with appropriate adaptations to support a service user who may have mobility restrictions. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 17 Communal areas are proportionate to the number of service users and staff on duty The weather on the evening of the inspection was very hot and there was evidence of fans maintaining the temperature to an acceptable level. A conservatory led to a well-maintained garden. The kitchen area was tidy, with work surfaces clean, and all perishable foodstuffs appropriately refrigerated. Kitchen equipment, such as the cooker, refrigerator, and freezer were suitable in capacity for the needs of the service users. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 18 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) 35 The staff on duty appeared to be knowledgeable about the service user group, and were committed to improving the quality of life for the people they care for. EVIDENCE: A member of staff on duty who had recently been appointed to the team, expressed his satisfaction with the induction process, and felt that he had been well informed about the needs of the service users, and the aims and objectives of the organisation. He was looking forward to beginning his National Vocational training. Staff interviewed confirmed that they had been issued with contracts and a copy of the General Social Care Council code of conduct. Staff said that they had been trained in statutory training such as fire (due to be updated shortly), food hygiene, manual handling. However training in Epilepsy and dementia has not been provided. This is of some concern since some of the service users have a diagnosis of these conditions. (This is the subject of a requirement) Staff were observed throughout the inspection to be interacting well with the service users, were good listeners and communicators and appeared to be St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 19 interested, motivated and committed in developing and maintaining close meaningful relationships with service users. Staff and service users both state that staffing levels were adequate. This was further supported from relative’s comments within pre-inspection questionnaires. St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 20 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) 38 and 42. The home is managed efficiently at the present time by an Acting Manager from another home owned by the Royal Mencap Society. EVIDENCE: Staff spoken to stated that they found the Acting Manager to be approachable, could talk to her with ease, and felt confident that problems would be dealt with in a professional way. Staff indicated that they have a good understanding of their responsibilities regarding health and safety. The Inspector examined the fire logbook, which confirmed that the equipment had been serviced regularly, and that a fire drill had been carried out during the previous month. Weekly tests are normally carried out although it was noted that there had been an elevenday gap since the last test. Gaps in the weekly tests were noted in the last inspection.( This is the subject of a recommendation). St Albans Close C51 C08 S12920 St Albans Close V232699 180705 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 2 3 x x 2 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 x x x x 3 Standard No 11 12 13 14 15 16 17 3 3 3 2 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 St Albans Close Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x 3 x x x 2 x C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 22 Yes 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 1 Regulation 4 Requirement The Statement of Purpose must include all information as detailed in Schedule one of the Care Homes Regulations 2001(Unmet from 30th August 2004) All service users must have a statement of Terms and Conditions including the amount and method of payment of fees and setting out the provision of services and facilities provided( Unmet from 15/03/05. A system of stock control must be put in place for medication that is not given on a regular basis. Training must be arranged for staff in Dementia care and epilepsy Timescale for action 30/09/05 2. 5 5 30/09/05 3. 20 13 31/07/05 4. 35 18 31/10/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard 14 Good Practice Recommendations Records should be completed to provide evidence that C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 23 St Albans Close 2. 42 service users who spend time in the house are offered opportunities of appropriate leisure activities. Fire tests should be carried out on a weekly basis St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor, Newland House Campbell Square NN1 3EB 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. Extracts may not be used or reproduced without the express permission of CSCI St Albans Close C51 C08 S12920 St Albans Close V232699 180705 Stage 4.doc Version 1.40 Page 25 - 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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