Inspection on 10/03/08 for The Poplars

This inspection was carried out on 10th March 2008.

CSCI found this care home to be providing an Poor service.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Poplars 10/09/09

The Poplars 14/08/08

The Poplars 17/09/07

The Poplars 15/12/05

The Poplars 08/09/05

The Poplars 08/02/05

The Poplars 21/10/04

The Poplars 19/02/04

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOME ADULTS 18-65 The Poplars Drayton Road Abingdon Oxfordshire OX14 5HY Lead Inspector Nancy Gates Unannounced Inspection 10th & 12th March 2008 09:30 The Poplars DS0000013126.V359492.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 The Poplars DS0000013126.V359492.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. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Poplars Address Drayton Road Abingdon Oxfordshire OX14 5HY 01235 523630 01235 523630 haroon@caretech-uk.com 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) Caretech Community Services Limited vacant post Care Home 6 Category(ies) of Learning disability (6) registration, with number of places The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Admittance of one named over age service user Date of last inspection Brief Description of the Service: The Poplars is a large detached house situated within easy reach of Abingdon town centre. The home is registered for up to six people who have a learning disability. The home has a spacious lounge, kitchen and dining room and a large garden with patio area. Each resident has his or her own bedroom. Each resident is supported to use local health care facilities. The home is run and managed by CareTech Community Services Ltd, a national organisation with experience in providing services for people with a learning disability. The fees for this home range from £997.72 to £1,015.19. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 0 stars. This means the people who use this service experience poor quality outcomes. The inspection of the service was a surprise visit and was a ‘key inspection’. We spent two days at the home arriving at approximately 9.30 a.m. on both days. The total number of hours spent during the site visits to the home was 14 hours. An ‘expert by experience’ assisted with the site visit on the first day. An ‘expert by experience’ is a person who, because of their shared experience of using services, and/or ways of communicating, visits a service with an inspector to help them get a picture of what it is like to live in or use the service. Experts by experience are authorised on behalf of CSCI to inspect care services as part of our inspection responsibilities with their main aim to look at the quality of the outcomes for the people who use the service. The ‘expert by experience’ asked for the views of a number of people who live in the home and also took time to look around the home. The findings of the ‘expert’ are written in italic within the report. The second day was conducted alongside the service manager, an area manager and the Caretech Director of Quality. The time spent at the home allowed for a thorough look at how well the service is doing. The inspection took into account detailed information provided by the service manager inclusive of information that CSCI has received about the service since the last inspection. All information received since the last inspection, about this service was also taken into account when producing the key inspection report. Staff and the people who live at The Poplars were very welcoming. We looked around the home including the bedrooms of individuals at their invitation. A number of records were viewed including individuals care plans, staff recruitment records, medication records and maintenance/health and safety records. We looked at how well the service was meeting the standards set by the government. The report includes judgements about the standard of the service. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 6 What the service does well: What has improved since the last inspection? What they could do better: People’s support plans remain bulky and contain a lot of information that doesn’t need to be used on a daily basis. The people who live at The Poplars people have lots of opportunities to go out, however activities and support in the home are limited and staff do not always engage and interact with people. Food options have improved, however only one choice is available at each meal; the manager confirmed that people can have something different to The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 7 what’s on offer but options should be made available to people before meals are served. A record of what people have eaten is not made; therefore, it is not clear how an assessment of whether people are receiving a balanced and nutritious diet can be made. Improvements need to be made to the storage of some medicines to ensure the safety of people who live in the home. On two occasions staff were seen to support a person to go out with the use of a wheelchair, on both occasions the person was wearing their slippers, staff did not acknowledge that the person might wish to change their footwear. This shows a lack of awareness and understanding of an individual’s appearance and supporting a person’s dignity. At times agency staff and the permanent member of staff were observed to have little or no interaction with individuals, they did not make sure that people were engaged in an activity. On these occasions, staff showed little initiative and a reluctance to interact with people. The quality of service offered to the people who live at The Poplars was again compromised. Efforts to employ a well-motivated and skilled staff must continue to reduce the use of agency staff to provide people with stability and continuity of care. Some improvements have been made to the house but a number of issues remain with the maintenance and safety of the home. Attempts were made to put things right within our visit but the length of time taken to put things right demonstrates that the living space and safety of the people who live in the home is not respected; people have to ‘make do’ with the house they are supported to live in. Action has only taken as a result of an inspection visit rather than providing a safe and comfortable living space for the people who live in the home. Due to the issues raised within our visit the health, safety and welfare of the people who live in the home is not promoted and protected. A number of areas for improvement remain and requirements made at the previous inspection have not been met within the required timescales. This means that we will now take action to enforce the requirements. 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. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. An assessment of the needs of a person who wants to move to the home can be completed following guidelines and a procedure available at the home. EVIDENCE: No one new has moved to the home since the last time we visited. People do not move in until a needs assessment has been completed, have visited and have stayed overnight (if possible). Following the assessment and visit(s) the service is then able to confirm whether they can meet the needs of the person and are sure that the person is happy to move into The Poplars. We looked at information about the people who live in the home, which was written before they moved in to see whether it describes how they like and need to be supported. The information held about the most recent person who moved in showed us that their needs and how they want to be supported was clearly recorded. The person told us that before they moved they were asked about the things they like and don’t like, about how they want to be supported and whether they liked the house. The person also confirmed that their family were asked The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 10 their views. This shows that the service will make sure as far as possible that peoples’ needs can be supported at the home and that people are happy to move in. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 11 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 & 10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Support plans and personal information support the needs of the people who live in the home, however information about how to support an individual on a day to day basis remains difficult to find. Risks associated with some lifestyle choices are assessed to support people to be as independent as possible. EVIDENCE: We looked at the support plans of four people who live in the home. The plans provide information about likes and dislikes, highlighting how people wish to be supported and include information about a person’s communication support needs. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 12 We have highlighted areas for improvement at three previous inspections and the service manager has made a number of changes to the quality of the information/plans, recognising that plans should reflect who people are as individuals. The plans include pictures and photographs to show how people wish to be supported, however the plans remain bulky and information about how to support individual on a day to day basis remains difficult to find. It remains unclear how people are supported to have an understanding of the information and who can have access to it. When we looked at the support plans on the first day two contained information provided to people about the home and how to complain, but the name and a photograph of the previous service manager were included within the documents. Visits by a representative of Caretech in January and February 2008 highlighted that the changes need to be made and the changes were made by our second visit, however this highlights that that action is only taken as a result of an inspection visit rather than updating information on a regular basis and ensuring that information for the people who live in the home is relevant. The home continues to have a system for identifying and assessing risk for individuals in relation to everyday activities and lifestyle choices meaning that people are protected as far as possible. From the evidence seen and comments received, we consider that this service would be able to provide a service to meet the needs of individuals of various religious, racial or cultural needs. Support plans are now held in a cupboard within the dining room rather than being placed on a window sill. On the first day of our visit support plans remained easily accessible as the cupboard was not locked, by the second visit a lock had been fitted to the cupboard. Whilst this secures the files it does not demonstrate how people are supported to have ownership of the information and who can access it. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 13 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, 15, 16 & 17 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. People are supported to make lifestyle choices, which generally recognise individuality but staff have a lack of understanding of how to engage people in activities in the home. Important relationships and contact with family members is supported and encouraged. Food in the home is of a satisfactory quality, however people are not offered a variety of choices on a daily basis. EVIDENCE: The ‘expert by experience’ talked with people who live in the home about things they like to do and noted the following things: Some good things we noted; The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 14 People have a wide variety of day and evening activities and are encouraged to take part in things they might like. They access normal community places and got there by walking, taxi, bus [people had passes] & using the house car. People also have visited lots of different places; Abingdon, Didcot, Oxford, London, Bristol and staff were enthusiastic about people’s holidays and trips out. We also talked with people about what they can choose to do. People told us that they are supported to go out to the shops, for a walk, to the pub and also have the chance to choose to go to lots of different places. Some of the people who live in the home attend college courses and a local day centre, which gives people opportunities for personal development. External Activity Support Workers (ASW) continue to offer people the opportunity to go out, to go shopping, to go out for lunch or to go to an activity. People are clearly supported to decide what they want to do during the sessions with the ASW. Whilst people have lots of opportunities to go out, activities and support in the home are limited and staff do not always engage and interact with people. For one person we found that they spent most of their day in their room listening to music with limited interaction from staff. The persons support plan and day planner on the dining room wall said that the activities they were due be involved in were ‘colouring’ in the morning and ‘drawing’ in the afternoon. We didn’t ‘t see the person engaged in an activity and whilst colouring and drawing maybe be a favourite or chosen activity it doesn’t demonstrate that people are supported to do a variety of things. There was an occasion where two people were seen to be wandering around the house not engaged in any activity, the staff were completing paperwork on the dining room table and ignoring what people were doing. One person was wandering around eating a bag of crisps, and when the Caretech Director of Quality questioned staff a staff member responded by trying to take the crisps away from the person, instead of engaging the individual in an activity. When questioned staff felt that they needed to complete the paperwork before they left for the day as they only had one and a half hours before the end of their shift. Whilst there has been an improvement in the activities available for people outside of the home, staff do not engage people in activities and showed little understanding of how to ensure that they meet people needs. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 15 On two occasions staff were seen to support a person to go out with the use of a wheelchair, on both occasions the person was wearing their slippers, staff did not acknowledge that the person might wish to change their footwear. This shows a lack of awareness and understanding of an individual’s appearance and supporting a person’s dignity. People continue to be encouraged and supported to maintain contact with people who are important to them. Visitors are welcomed into the home, an individual told us, “ I see my mum lots of times and can talk to her on the phone when I want”. The ‘expert by experience’ noted that, “It was good to hear that friends and relatives were welcome and frequent visitors and joined in parties and activities.” The people who live in the home continue to attend house meetings and are given opportunities to share their views on issues that are important to them. The ‘expert by experience’ also found that, “there are regular meetings and people are helped through ‘talk time’ to tell staff about concerns, worries etc. One person goes to an advocacy group.” People confirmed that they help with the menu planning and that some people help with the preparation of meals. The ‘expert by experience noted, “People are encouraged to develop their self-help skills; cooking for themselves and the group, washing and shopping.” A four week ‘rolling’ menu ahs been developed. The manager stated that lighter lunches are available an efforts are being made to include healthier options and more vegetables. Regular drinks and snacks are available, one person was seen to help themselves to hot drinks to crisps and chocolate. Menus detail that people choose what they want for breakfast, usually cereal and/or toast. The options for lunch and dinner now offer people more vegetables and healthier options but convenience foods remain on the menus. Only one choice is available at each meal; the manager confirmed that people can have something different to what’s on offer but options should be made available to people before meals are served. A record of what people have eaten is not made; therefore, it is not clear how an assessment of whether people are receiving a balanced and nutritious diet can be made. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 16 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. The people who live at The Poplars are supported to meet their personal care needs. Access to additional support from health care professionals is consistent and meets individuals’ health needs. Medication is stored securely and administration is accurate, ensuring the safety of the people who live at the home. EVIDENCE: Support/care plans include guidance of how people wish their personal and healthcare needs to be supported. Personal care is provided in private in either people’s bedrooms or the bathrooms. People are prompted with their personal care as needed and they choose their own clothes and hairstyle. Times for getting up, going to bed, and mealtimes remain flexible. Support plans refer to preferred routines, likes and dislikes. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 17 On two occasions staff were seen to support a person to go out with the use of a wheelchair, on both occasions the person was wearing their slippers, staff did not acknowledge that the person might wish to change their footwear. This shows a lack of awareness and understanding of an individual’s appearance and supporting a person’s dignity. The ‘expert by experience’ confirmed that, “People can choose what time they go to bed. There are no house rules; staff encourage residents to do the things they want.” People are supported to see their local GP and other community healthcare services when needed. Staff also support people to access specialist healthcare support. Staff continue to support people to take their medication. Medication storage and administration records (MARs) were viewed. Two lockable cabinets, which are securely attached to the wall, ensure the safe storage of medication. Medicines were found to be in date and stored appropriately. There were no inappropriate items stored in either cabinet. Medication administration records were well maintained with signatures alongside prescribed dose times. The manager and staff should make sure that a date of opening is put onto bottles and boxes to ensure that if medication is ‘carried over’ from one month to the next a clear audit trail of the amount of medication that should be available can be made. Staff administering medication have been trained ‘in-house’ and have completed a period of observation before being signed off as competent. Further training for staff (including agency staff) is being held in the near future. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 18 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 adequate. This judgement has been made using available evidence including a visit to this service. The home has an effective system in place for responding to, investigating and recording complaints. Systems and procedures are in place to ensure the protection of the people who live in the home, however staff training needs to be completed to ensure people are appropriately protected. EVIDENCE: No formal complaints have been received at the home or at the CSCI since the last inspection. A complaints procedure is available for the people who live at The Poplars, however the information needs to be updated to include the current contact details of the CSCI. Individuals confirmed that they know who to talk to if they’re not happy with something. Adult protection/Safeguarding adult’s procedures are available at The Poplars. The manager and the one permanent member of staff have attended Safeguarding training but have not attended training updates. The manager stated that all staff, including agency staff are responsible for personal reading to have an understanding of the Safeguarding adults procedure. All staff must receive the appropriate training to safeguard people who live in the home to ensure consistent knowledge and response. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 19 We looked at the homes procedures for supporting people to manage their money and we also looked at how staff record the amount of money available to individuals. For one person the amount of money available didn’t match the amount recorded on the person’s expenditure sheet by a small amount but this shows that staff need to be accurate in recording what’s available to people. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 20 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 & 30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The home is generally comfortable, however there must be improvements made to some of the personal and communal areas to ensure the safety and comfort of all household members. The home is not clean in all areas. EVIDENCE: The home is a detached property, close to local facilities and shops. Most areas within the home other than some people’s bedrooms were seen with the permission and assistance of individuals and the in presence of the Director of Quality on the second day. All of the shared spaces within the home are accessible for shared and private use. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 21 Communal areas were warm and remain decorated to a reasonable standard. The dining room contained a large table and numerous chairs. A large kitchen allows for people to make drinks and snacks whenever they wish. A lounge area is opposite the dining room and contains comfortable sofas, a TV and DVD. Peoples’ bedrooms reflect individual tastes, containing personal effects that ensure that who they are as individuals is recognised. People commented that they like the house and their bedrooms, “I’ve got all my things that I want.”. A tour of the building was conducted on the first and second day of the visit and the following issues were raised: Ground floor • • • Lounge - Curtain pole to one window was missing. Tabs on the curtains for the main window were broken. The curtain pole was repaired by our second visit Dining room – Dirty/grubby edges of the floor to the skirting boards, hanging tabs on two of the curtains were broken. Cobwebs were present in the corners of the room. Kitchen – remains functional but not homely. No blind at the kitchen window. The ‘Expert by Experience’ commented on the kitchen, “The kitchen was still not very friendly; a bit too big and open, but we could see it was nicely fitted and decorated… The kitchen could have been a much easier room to hang around in; there was nowhere to sit and chat easily.” The ‘Expert by Experience’ highlighted that a rear door to the property was locked but had a fire exit sign above it. The manager stated that a key was not available to unlock the door and that the maintenance department of the housing provider were due to ‘sort it out’. The manager was unclear as to whether the door was an identified fire exit. A floor plan of the home that identifies fire exits was not available. Toilet – a toilet is situated on the ground floor and has been identified as a ‘staff toilet’. It is not accessible to the people who live in the home due to one persons support needs and is therefore locked with a bolt on the outside when not in use. The people who live in the home are expected to use the upstairs toilets at all times but there was no clear explanation of why the toilet cannot be adapted to meet the needs of all of the people who live in the home and is only for the exclusive use of staff. Staff sleep-in room - the room remains untidy. There are numerous boxes that contain archived files; this compromises the safety and confidentiality of information. A mattress protector sheet pinned to the window frame was being used a curtain, in an attempt to provide privacy for staff. The sleep-in bed provided for staff is grubby and in need of replacement. DS0000013126.V359492.R01.S.doc Version 5.2 Page 22 • • • The Poplars • • Gas Boiler – the gas boiler remains situated next to a fire exit and adjacent to an individual’s bedroom, although a fire door provides protection. A part of the front cover of the boiler was still missing, providing easy access to the boiler, this does not ensure the health and safety of household members. A broken wardrobe door was propped against the wall next to the boiler by a member of staff, partially blocking the fire exit, this again does not ensure the health and safety of household members and shows a lack of understanding of fire safety issues by staff members. The ‘Expert by Experience’ commented about one person’s bedroom. “One bedroom had shutters on the outside because the person whose room it was did not like curtains/tore them down. One shutter had a broken latch, which meant it was left closed [this means the room has only ½ the light it should have. The room was very bare [there may be good reasons for this, but there may be ways of making it less cold looking…and the same for the persons next door bathroom/toilet].” The bathroom was bare and cold and had a strong, stale odour. First floor • Bathroom – Bath, cracked, broken and stained enamel surface, the edging of the bath was dirty and mouldy, tile grouting is dirty. No blind at the window to provide privacy. The window does not fully close, therefore the bathroom is cold at all times. The bathroom had a strong stale odour. A shower attachment is available on the taps but cannot be used as a shower as a curtain or screen is not available, people can only have a bath. Windows – The windows on the landing do not fully close. The window in the toilet does not fully close. No liquid soap or towels were available in either of the toilets (upstairs and downstairs) or in the bathroom. Upstairs toilet – no indicators on the taps to show which tap was hot and cold, the flooring is stained and broken at the edges Fire exit alarm – did not work at our first visit but was repaired during the visit. The ‘Expert by Experience” identified, “One person’s room had a chair that needed replacing; it had sharp screws sticking out where the back cushion had worn away”. • • • • • When we visited the home in September 2007 a number of carpets throughout the home had been identified as needing replacement. The carpets have been cleaned but remain stained and unsightly. Reports of visits made by representatives of the provider highlight that maintenance issues remain and that the home manager is working towards the requirements we made at our visit in September 2007. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 23 It was disappointing to find that a number of areas for improvement remain and that requirements made at the previous inspection have not been met within the required timescales. This means that we will now take action to enforce the requirements. Action taken by the housing provider and Caretech within our visit demonstrates that the living space and safety of the people who live in the home is not respected; people have to ‘make do’ with the house they are supported to live in. Action has only taken as a result of an inspection visit rather than providing a safe and comfortable living space for the people who live in the home. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 24 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, 33, 34 & 35 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. High use of agency staff compromises the quality of service offered to the people who live in the home. The home does not have sufficient permanent staff to meet identified needs. Safe recruitment practices are in place, which safeguard the people who live at the home. Staff are offered mandatory training, which ensures that the needs of people who live at The Poplars can be met by appropriately trained staff. EVIDENCE: Upon arrival at the home on the first day, there were two agency staff on duty, one permanent member of staff and the manager present. The manager and one support worker are the only permanent members of staff available to support the needs of the people who live in the home. There The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 25 continues to be high use of agency staff as there are numerous staff vacancies. The ‘Expert by Experience noted, “People get the same agency staff coming in for consistency and take care to make agency staff part of the team [e.g. by involving them in training sessions].” The manager stated that preferred staff from one agency are used to ensure consistency, however the skills and abilities of those staff are again questioned due to the observations made during the inspection. (Please see the ‘Lifestyle’ section of the report). It has been highlighted that there were occasions when people were not engaged in any activity with staff. At times staff were observed to have little or no interaction with individuals, showing little initiative and a reluctance to interact with people. The quality of service offered to the people who live at The Poplars was again compromised. The wardrobe door propped against the wall near a fire exit by a member of staff highlights a lack of understanding of fire safety issues. Safeguarding adults training for all staff was not up to date, but we recognise that a training day was due to take place in the near future. We recognise that continue efforts are being made to recruit permanent staff to support the people who live in the home, however the registered provider must ensure that a skilled and experienced staff team is on duty at all times. A number of areas for improvement remain and requirements made at the previous inspection have not been met within the required timescales. This means that we will now take action to enforce the requirements. A Caretech training programme is available for all staff, including agency staff. The courses include fire safety, manual handling, first aid, medication administration, food safety and courses relevant to supporting the people who live in the home, however it is clear that refresher training is needed to ensure people are aware of their responsibilities for the health, safety and welfare of household members. The one permanent staff member has not completed a relevant National Vocational Qualification (NVQ). The home continues to not meet national targets to have 50 of staff NVQ qualified. A recruitment checklist confirms that information needed for the protection of the people is held by the organisation. The manager confirmed that appropriate recruitment checks are made by the organisation before employment, which ensures the protection of the people who live in the home as far as possible. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 26 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 & 42 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service. The manager is appropriately qualified and has the necessary experience to run the home. The health, safety and welfare of the people who live in the home is not promoted and protected. EVIDENCE: The manager has a range of skills and experience to support the needs of the people who live at The Poplars, has achieved an NVQ level in care and is aiming to achieve the Registered Manager’s Award in the future. When we visited the home the manager had not sent us an application for registration. The provider must ensure that the manager submits an The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 27 application for registration to ensure that the day-to-day and ongoing development of the service are managed effectively and the service remains in line with legislation. Staff and the people who live in the home described the manager as being, ‘nice…happy…helps me’, and as being “supportive and good at listening”. The ‘Expert by Experience’ made the following comments, “This home feels like a well run, happy, friendly place, it has a nice ‘homely’ feel, was welcoming and people seem at ease with visitors”. Some action has been taken to respond to requirements from our last visit, however the health, safety and welfare of the people who live at the home is not fully recognised and respected as a number of issues remain. A number of areas for improvement remain and requirements made at the previous inspection have not been met within the required timescales. This means that we will now take action to enforce the requirements. Regular visits have been completed by a representative of the provider to evaluate the quality of care and service provided, the reports of the visits were available. Due to the remaining issues regarding staffing, staff knowledge and competence and the health and safety issues for the people who live at the home the provider must send us copies of the reports made following future. This will enable us to monitor what issues are raised and the actions taken. The home has appropriate policies and procedures available to protect household member and staff. A range of health and safety checks continue to be carried out at the home, however a fire safety folder was not available and could not be found, this means that we were not able to see that all checks of the fire safety systems are being made on a regular basis. Permanent and agency staff undertake training in control of substances hazardous to health and health and safety, as well as manual handling, food handling and first aid. Data sheets were in place for cleaning products used at the home, in case of accidental spillage or ingestion. CareTech (the registered provider) has financial and accounting systems subject to internal and external audits. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 28 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 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 1 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 1 33 1 34 3 35 2 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 2 X 2 2 LIFESTYLES Standard No Score 11 X 12 2 13 3 14 X 15 3 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 2 X 3 X X 1 X The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 29 Are there any outstanding requirements from the last inspection? Yes 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 YA28 Regulation 23:3 Requirement Timescale for action 31/05/08 2. YA42 23:4 3. YA39 26 The registered provider must ensure that sleeping in facilities provided for staff are clean, tidy, has good quality furniture and has window coverings that respects the privacy of people using the room. The registered provider must 30/04/08 consult with the local fire authority to ensure that the fire safety systems and safety checks meet obligations under fire safety legislation and protect people who live in the home. The registered provider must 30/04/08 ensure that a report of the unannounced visits by representatives of the organisation are provided to us on a monthly basis to enable us to monitor what issues are raised and the actions taken. The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 30 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. 3. Refer to Standard YA6 YA12 YA17 Good Practice Recommendations The registered provider should review support plans to ensure they contain relevant information to support people who live in the home on a daily basis. The registered provider should review activities available to people when they are at home to ensure individuals are engaged in age, peer and culturally appropriate activities The registered provider should offer people a variety of food options, should make a record of what people have eaten throughout the day to ensure that they are receiving a balanced and nutritious diet. The registered provider should ensure that when staff support people to go out they consider individuals dignity at all times. The registered provider should make sure that a date of opening is put onto bottles and boxes to ensure that if medication is ‘carried over’ from one month to the next a clear audit trail of the amount of medication that should be available can be made. The registered provider should ensure that staff receive Safeguarding Adults training on a regular basis to protect the people who live in the home. 4. 5. YA18 YA20 6. YA23 The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 31 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 The Poplars DS0000013126.V359492.R01.S.doc Version 5.2 Page 32 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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