Inspection on 19/08/05 for The Thomas More Project - 97 Cromwell Road

This inspection was carried out on 19th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

The Thomas More Project - 97... 20/02/07

The Thomas More Project - 97... 06/12/05

The Thomas More Project - 97... 31/01/05

The Thomas More Project - 97... 13/07/04

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2 Perhaver Park

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St George`s

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Credence House

Radfords

Honeybourne House

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

CARE HOME ADULTS 18-65 97 Cromwell Road 97 Cromwell Road St Andrews Bristol BS6 5EX Lead Inspector Sam Fox Unannounced 19 August 2005 09:30 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. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 97 Cromwell Road Address 97 Cromwell Road St Andrews Bristol BS6 5EX 0117 9423739 0117 9423739 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) Thomas Moore Project Miss Andrea Jackson PC Care Home Only 6 Category(ies) of LD Learning disability, for 6 registration, with number of places 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: May accommodate persons aged between 25 - 64 years. Date of last inspection 31 January 2005 Announced Brief Description of the Service: Cromwell Road is operated by the Thomas More Project, a charitable organisation, which provides support for people with learning difficulties. The present age range is between 25 yrs to 64 yrs - the home, however, have recently submitted an application to reduce the age range so they can accomodate a new resident who is 20 yrs old. The house itself is residential in style and blends in well with the local community. It is close to many local facilities and amenities. The home has its own transport. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, the purpose of which was to ensure that the home was being well maintained and that residents were happy. Health and safety issues and care plans were also looked at in detail. Evidence was gathered through discussion with residents and staff, observation and inspection of records. What the service does well: What has improved since the last inspection? Cromwell Road continues to maintain previously good standards which were acknowledged at the last inspection. They encourage residents to lead active lifestyles within a risk-assessed framework. Improvements continue to be made to the décor so residents benefit from living in a homely and comfortable environment. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 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. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2, 3, 4,5 There is an effective and considered admissions procedure in place so new residents can be confident that the home will have the resources and skills to meet their needs. EVIDENCE: The home has a Statement of Purpose and a service users guide. These were not looked at in detail at the time of this visit but have been viewed on previous inspections. Cromwell Road has one vacancy and someone is interested in moving in. There was a full assessment available from a social worker and correspondence to evidence that the home are trying to establish whether they have the resources and skills to meet this persons needs. This is good practice and meets with requirements of the legislation. Records and discussion with staff indicated that the prospective new resident has visited the home on a number of occasions to have tea and find out more about the home. Other residents explained that they had met, and liked her. It is important that consideration is given to all members of the household during this process. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 9 There were completed contracts issued both by the Thomas Moore Project and Knightstone Housing Association (who own the property). These provide information about some of the terms and conditions of living at the home. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.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) 6,9,10 Care plans are written to good detail and regularly reviewed which enables the home to provide a consistent and individualised service. Residents are fully involved in this process so they can be assured that their personal preferences will be included. EVIDENCE: Opportunity was taken to look at two personal files. These were found to contain general information, personal profiles and initial assessments. In addition to this each resident has a number of personal support plans which highlight the support needed for them to go about their daily living. These range from general household safety, family contact, personal hygiene and safety in the community. They evidenced that the home provides a holistic service, which takes into account physical, emotional and social needs. They were written to good detail and are reviewed at regular intervals with the resident concerned, who signs their agreement. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 11 Discussion with residents and records also evidenced that residents are supported to take risks according to their ability and health and safety needs. Some residents are able to access community facilities on their own, one is supported to self medicate and can also stay at the home alone for limited periods. Staff provide a flexible service that promotes independence in this respect. Issues relating to confidentiality are discussed during the induction process and records are kept secure in a locked office. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.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) 12, 13, 14, 15, 16 Staff provide comprehensive support for residents with their activities and hobbies which enables them to lead active and interesting lifestyles. EVIDENCE: Residents talked about what they liked to do throughout the week. It was apparent that they have varied interests and activities. One resident, for example is supported to work, others attend college courses and one resident attends a resource activity centre. They spoke animatedly about what they did and it was clear that they enjoyed them and that they were meaningful. Residents have recently been on holiday abroad and they said they were looking forward to future trips as they had had such a good time. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 13 One resident talked about his family and explained that he goes to stay with them at regular intervals. There were personal support plans which gave guidelines as to the support needed for residents to maintain such links. One resident recently lost a close member of their family and it was apparent that this was dealt with in a sensitive manner by the home. Some residents are able to access community facilities independently, others require staff support for this. Records provided evidence that the appropriate assessments have been made to ensure the safety of residents. It was apparent through discussion with two residents that they liked where they lived and felt part of the community. They said they have good relations with their neighbours. Residents were observed taking responsibility for household chores and they explained that they had allotted tasks which best suit them. In addition to this they do their own washing and participate in the cooking. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.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) 18, 19, 20 There are good systems in place to ensure that residents physical and healthcare needs are met. Improvements need to be made to the storage and stock checking of tablets given on an as and when basis so that the medication system is safe. EVIDENCE: Some residents require support to maintain their personal hygiene. There were clear guidelines about this which were written to good detail and took into account individual preferences. They are regularly reviewed, updated and signed by residents. This is good practice. There is a relatively small staff team at Cromwell Road, many of whom have worked with residents for some time. They have been able to get to know their needs and how to assist them in a sensitive manner. Records provided evidence that residents continue to be supported to see the relevant health professionals and specialists. In addition to this they are encouraged to attend regular check ups, for example to the opticians, chiropodist and dentists. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 15 Records held in relation to the administration of medication were found to be well maintained and met with the requirements of the legislation. It was noted, however, that there was a surplus of paracetamol which had been taken out of their original packaging and had not been recorded on the stock check. The home must ensure that all tablets are kept in their original packaging and accounted for via a regular stock take. One resident self medicates and there are systems in place to ensure that this is achieved safely. It is good practice to promote residents independence in this respect. One resident who used to live at the home died last year and residents were sensitively supported throughout this difficult time. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 There is an open and relaxed atmosphere fostered within the home so residents can be re-assured that they will be listened to. EVIDENCE: There was an open atmosphere in the home and residents contributed actively to the inspection process. It was apparent that they were not afraid to speak their minds. They said that they would feel confident to complain or speak with the manager if they were unhappy. The Thomas More Project has a formal complaints procedure which is included in the home’s statement of purpose and residents guide. This highlights timescales for action and meets with the requirements of the legislation. There have been no complaints received by the home or CSCI since the last inspection. Training records evidenced that staff have had training about indicators of abuse and what to do in such circumstances. The home also has a policy about the reporting of suspected abuse. Additional individual guidelines may have to be written for a prospective new resident for whom particular concerns have been raised. This will be a focus of the next inspection. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 17 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, 26,27,28, 30 Residents benefit from living in a clean, homely and comfortably furnished house. EVIDENCE: Cromwell Road is residential in style and has three storeys and a basement. It is homely in appearance and all areas were found to be comfortably furnished. There have been some improvements to the décor, including, new carpets and re-decoration of the hallways. This has made the area, which has no natural light, brighter and represents a considerable improvement. The home has a secure back garden which residents help to maintain. They have also adopted a stray cat that is well loved. Opportunity was taken to view a number of bedrooms (shown by the residents). These continue to be personalised and to reflect individual tastes. It was noted that a number of the bedroom carpets were looking jaded in appearance, are old and, in some instances, appear institutional. The home should begin a planned programme of replacing these. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 18 Residents explained that they had their own bedroom door key, which they use to maintain their privacy and keep their personal possessions secure. Those consulted with said they were satisfied with the quality and quantity of furniture they had. There are sufficient bathing facilities to meet with the needs of those residents currently accommodated. It has been a number of years since the bath and shower room has been upgraded. It is recommended that consideration be given to refurbishing these. Residents’ benefit from the use of a large dining area in the basement which leads directly on to the kitchen. These were found to be adequately equipped. There was a broken light fixture which needs replacing in the dining room. It was also strongly recommended that consideration be given to changing the strip lighting as this can look institutional. Generally all areas of the home were found to be cleaned to a good standard. There have been some issues in relation to the cleaning which are currently being discussed by the manager with the staff team. This will be a focus of the next inspection;. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 19 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) 32,33,34 There is a robust recruitment procedure in place which provides further protection for residents. Staffing levels are at a minimum and should be reviewed so that residents know they will be effectively supported at all times. EVIDENCE: The home employs five staff, including the manager and this was a source of concern, as it does not leave much leeway if staff are on holiday or go off sick. Rotas provided evidence that there is one staff on duty at all times with a flexible shift that is used during waking hours dependent on planned activities. Some residents need support to go out and the home is intending to admit a new resident soon. The home must review these staffing levels to ensure that they are adequate to meet with the needs of those residents currently accommodated. Opportunity was taken to view the personal file of one of the newest recruit. This included a full application form, references and criminal records checks. This system is well maintained and provides residents with extra protection. There was also evidence that the member of staff had had a full induction and additional supervision, during which time teething problems were discussed. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 20 The home has a formal supervision system, which provides staff with a means to discuss their concerns and developmental needs. Records indicated that these are held at regular intervals. Records provided evidence that staff meetings take place at regular intervals. It was noted that there have been some difficulties within the staff team – it is important that these are resolved so that it does not impact upon the service received by residents. This will be a focus of the next visit. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 41,42 There are effective systems in place for the maintenance of health and safety so residents can be confident that their safety and welfare will be promoted and protected. EVIDENCE: There are good systems in place for the management of health and safety in the home and members of staff are delegated responsibility for this. They are a number of monthly checks of the premises which are fully recorded. These were found to be up to date and comprehensive. Training records and certificates evidenced that staff have had their statutory training of first aid, basic food hygiene and manual handling. Fire records indicated that tests and checks take place of the system at regular intervals. There was a work place fire risk assessment and training records, which indicated that staff benefit from regular re-fresher fire training. 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 22 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 x 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 x x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x 3 2 3 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 97 Cromwell Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x x x 3 3 x D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 23 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. 3. 4. Standard 20 26 28 33 Regulation 13 (2) 16(2)(c ) 23(2)(b) 18(1)(a) Timescale for action Ensure medication is kept in its 19 August original packaging and accounted 2005 for. Implement a planned 30 October programme of replacing 2005 bedroom carpets Fix light fitting in dining area 15 September 2005 Review staffing levels 30 September 2005 Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard 27 28 Good Practice Recommendations Upgrade bath and shower room Change the strip lighting in the dining area 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.doc Version 1.40 Page 24 Commission for Social Care Inspection 300 Aztec West Almondsbury Bristol BS32 4RG 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 97 Cromwell Road D56_D05_S26533_CromwellRd_V244405_160805_Stage4.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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