Inspection on 12/10/05 for Ulysses House

This inspection was carried out on 12th October 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 25 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ulysses House 25/04/08

Ulysses House 15/10/07

Ulysses House 19/04/07

Ulysses House 10/10/06

Ulysses House 04/05/06

Ulysses House 27/04/05

Ulysses House 13/01/05

Ulysses House 01/09/04

Ulysses House 07/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 Ulysses House 28 Fountain Road Edgbaston Birmingham West Midlands B17 8NR Lead Inspector Sarah Bennett Unannounced Inspection 12th October 2005 09:30 Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ulysses House Address 28 Fountain Road Edgbaston Birmingham West Midlands B17 8NR 429 9555 0121 429 9555 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) Ulysses Care Limited Mr Nigel Lavender Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. Residents must be aged under 65 years. 26/7/05 – follow-up visit 12/8/05 – Pharmacy inspector Date of last inspection Brief Description of the Service: Ulysses House offers accommodation for up to six young adults with learning disabilities who present with challenging behaviour. Ulysses House is a large, three storey, semi-detached Victorian house. The home is located in a residential area in Edgbaston and is well served by public transport. It is within walking distance of local shops, pubs and restaurants, the centre of Bearwood and is a short bus ride from the centre of Birmingham. Each resident has their own bedroom that has been tastefully decorated, two of which have en suite facilities. The home has a large dining room and kitchen, comfortable sitting room and utility room/laundry. The staff sleeping in room is also used as the office. The home offers a bathroom on the first floor and a WC on the ground and first floor. The premises can accommodate fully mobile adults, and does not offer disabled access or adaptations. There is a large enclosed garden to the rear of the house offering a large patio area and a lawned area. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over six and a half hours. There are currently five residents living at the home, who were spoken to. The Manager and the staff on duty were spoken to. A partial tour of the premises took place. Care, staff and health and safety records were looked at. Stephen Ellis (expert by experience) and his supporter from ‘Sandwell People First’ were there for part of the inspection. As a service user Stephen has an expert opinion on what it is like to receive services for people who have a learning disability. Stephen’s comments are included throughout this report where he is referred to as ‘ex by ex’. What the service does well: What has improved since the last inspection? Residents have individual care plans and risk assessments so that staff know how to support individuals. Residents who want to are now going to college. Different activities are being found for residents to do so that they have more things to do each day. Four new staff have been recruited to work at the home. This means that agency staff who do not know the residents will not be needed to work there. Staff have received training in fire safety and test the fire equipment regularly to make sure it is working. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 6 A new medication cabinet has been bought so that medication can be stored safely and staff are signing to say that they have given medication to residents. 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. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 the following standard(s): 2 Prospective residents individual aspirations and needs are assessed. EVIDENCE: The manager has visited and completed an assessment on a prospective resident. This is detailed, specific and includes relevant information about the individual. It also included information about the individual’s goals and aspirations. The prospective residents community nurse was involved in the assessment. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 8, 9 Residents assessed needs and goals are reflected in their individual care plan so that staff know how to support each individual. Residents are consulted on but the arrangements for recording this are not adequate. Residents are supported to take risks within a risk assessment framework. EVIDENCE: The manager said that residents are involved in their care plans as much as possible. Resident’s records included individual care plans. These were detailed and stated how staff are to support the individual. When resident’s needs change e.g. they have dental pain, short-term care plans are put in place so ensuring they are given the right immediate support. The ex by ex said: “All the residents had a care plan. They were kept in the office. The manager said that the residents are included in writing their plans and that they have regular reviews”. The manager and residents said that every Sunday there is a residents meeting. The ex by ex said: “ Residents talk about what happens during the week”. Minutes of residents meetings were only available for three meetings in 2005. Staff said they are not always recorded. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 10 Resident’s records included individual risk assessments. These are detailed and state how the risks to residents are to be minimised without denying them the opportunity to take risks. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Generally arrangements are adequate to ensure that people living at the home experience a meaningful lifestyle. EVIDENCE: Two residents went to college supported by staff. They went by public transport. At college they do cooking and IT. One resident goes to a work placement four days a week. Residents said that they go out shopping with staff support and go by public transport. In the evenings they watch TV. One resident was planning to go shopping with a member of staff in the afternoon. Another resident was sitting with a member of staff sorting out their personal photographs and putting them into an album. Staff said that residents go to visit their relatives, supported by staff where appropriate. Relatives visit the home. Staff said that some relatives have not visited the home for a long time but are now being given the opportunity to do so. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 12 Residents said that they sometimes help with cooking and preparing meals. Residents who are able to were observed making their own drinks, when they wanted them. The ex by ex said: “ Residents help with the cleaning and sometimes helps with the cooking”. Staff said that one resident appears to have started washing their clothes in the sink in their bedroom. This has caused their bedroom carpet to become damp and soiled. Staff said this behaviour may be due to their past experience of living in a long-stay hospital where they may not always have had their own clothing or had it returned from the laundry. Residents said that the staff do the washing. The ex by ex said: “ I think that work needs to be done with this resident to make sure that he stops washing his clothes in the sink. If he were to be more involved in using the washing machine by taking his clothes in and out of the washing machine, then maybe he would have peace of mind that he would get his own clothes back”. Residents are weighed regularly and a record of this is kept. Records of food were not completed daily. Records of food available indicated that the resident often ate chips. From talking to the resident it is possible that this is their choice and it is evident that alternatives are offered to try to promote a healthy diet. The weekly shopping for this week had been ordered on the Internet and was delivered during the inspection. Adequate food stocks were available. The ex by ex said: “The manager told me that there is a set menu on a 4 weekly basis. I asked a resident if they were involved in writing the shopping list and they said ,“Yeah.” Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20 Adequate arrangements are in place to ensure that resident’s health needs are met. The arrangements for the management of the medication are not adequate to protect residents from harm. EVIDENCE: Residents were dressed appropriately according to their age, personal tastes and the activities they were doing. Residents talked about buying clothes with support from staff. The ex by ex said: “All residents can go to bed when they choose and get up when they want to”. Health professionals are involved in the care of residents including the psychiatrist, community nurse and psychologist. Resident’s records included details of medical appointments that residents had attended. These included the GP and dentist. A new medication trolley has been provided. Staff said this was delivered about a month ago with the wall fixings provided. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 14 However, the trolley has not been fixed to the wall to prevent it from being taken out of the home. Resident’s medication records include protocols for as required (PRN) medication stating when the medication should be given and what dosage. A protocol is in place for residents having homely remedies such as medication for colds and pain relief. All medication had been signed for as prescribed. At the visit by the pharmacy inspector some discrepancies had been found in, the amount of medication in the home. The manager said that audits are now carried out each week and there have been no discrepancies found. Staff have not received accredited training in the management of medication. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 the following standard(s): 22, 23 The arrangements for the management of complaints are not adequate to ensure that resident’s views are listened to and acted on. Some physical intervention recording is lacking and may impact on the homes ability to ensure that residents are being protected from abuse and that their welfare is being promoted. EVIDENCE: The complaints procedure was not looked at during this inspection. A complaints procedure was not seen displayed in the home or in resident’s individual records. Residents said that they would talk to the manager if they were unhappy about anything. One of the residents spoken to showed knowledge of the role of the CSCI in dealing with complaints and they were aware of who to speak to. The ex by ex said: “There were no simple instructions around the home about how or who to complain to. Residents said they would complain to the manager. My concern is that if residents had any complaints about the staff working with them they wouldn’t know where or who to complain to outside of the home”. Residents said that they have their own bank accounts. Residents said that they go to the bank to withdraw their money with support from staff. Residents also said that staff support them as much as they need to buy clothes and things for their bedroom. Receipts are kept of all money that residents withdraw from their account and of their purchases. The ex by ex said: “ Residents have their own bank account and can choose what they want to spend their money on”. Resident’s records included an inventory of their belongings. This had not been updated since June 2005. However, the resident said that they had bought several items of clothing since then. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 16 Due to their past experience when they lived in a long-stay hospital they expressed their anxiety of their clothes going missing. Therefore, it is important that these items are recorded so as to reassure them. Resident’s records included details of an incident where a resident had been verbally and physically aggressive towards staff resulting in the resident being restrained by staff to help them calm down. This had not been reported to the CSCI as required. The record of the use of physical intervention was not detailed. Records on the use of physical intervention require improvement to ensure they meet the Department of Health guidance for restrictive physical interventions (2002) and to show that service users are not subject to unnecessary intervention. Staff were talking to the manager about the best way to manage one residents behaviour so that all staff manage it in the same way and the resident does not become confused or frustrated by the response of some staff. Staff have received training in the use of physical intervention and individual behaviour management strategies are in place for residents. The manager said that training for staff in the prevention of abuse is booked for November 2005. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 the following standard(s): 24, 26, 27, 28, 30 The condition and maintenance of the home does not enable residents to live in a homely, clean and comfortable environment. EVIDENCE: In the kitchen the top drawer in one of the units was missing. The door of one of the wall cupboards was missing. The ex by ex said: “One of the drawers in the kitchen was missing. The kitchen cupboards didn’t look very clean”. Two residents bedrooms were looked at with the resident’s agreement. One resident said that they had not chosen the colour of their bedroom. However, a few days before, a company that provides astro ceilings had visited. The resident said the company would put stars and planets on the ceiling, which they are interested in. They have a telescope in their bedroom. They hope to have their bedroom redecorated in a colour of their choice. Their carpet was soiled and in need of vacuuming. Staff said that they had requested a new vacuum cleaner. The vacuum cleaner had been repaired with super glue. The residents carpet was very damp and they said it was because their sink was leaking. The ex by ex said: “One resident showed me his room. It didn’t seem to have a lot of his own belongings in it and the furniture wasn’t very nice. The carpet by the sink was wet. The carpet looked like it hadn’t been cleaned for some time.” Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 18 The manager said that the reason for the damp carpet has been investigated and there is not a leak. However, it appears that the resident has started washing their clothes in the sink. The other resident’s bedroom was very tidy and contained personal photographs and possessions. The WC outside the resident’s bedroom was blocked. The resident said that they do not use it as it is often blocked. Staff said that it had been unblocked several times in the last few months but it seems that this does not solve the problem and this must be investigated. In the dining room there is a pool table that residents use. The paint was chipped on several parts of the office walls. Staff said that the dishwasher was not working. This was not working at the last inspection. Staff said that the tumble dryer did not seem to be working properly and takes about five hours to dry clothes. This causes one resident to become anxious, as they like to know when their clothes are going to be dry. The aerials on the TV in the lounge and in one of the resident’s bedrooms were not connected to the outside aerial. The minutes of a residents meeting in August 2005 stated, “ three residents think maintenance work could be started sooner”, this included the TV aerial in the residents bedroom. Two of the five current residents smoke. The smoking area is a shed without a door, in the back garden. This is unacceptable in the winter months and in bad weather. An alternative smoking area must be provided. At the rear of the home there is a large enclosed garden with grassed areas and shrubs. Residents could be supported to participate in gardening and the garden developed so it can be used more by residents. The ex by ex said: “ There are repairs that need to be done around the home like the kitchen cupboard and the blocked toilet which I feel probably isn’t going to be done urgently if the provider is based in London and the provider has to organise for work men to come in. Overall I feel that there needs to be lots of improvement made to this home.” The inspector was concerned about the response to maintenance issues and felt that improvements were needed. Following this inspection a letter of ‘serious concern’ was sent to the owner about maintenance issues and the physical standards of the home. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35 The arrangements for staffing the home, their support and development was variable. EVIDENCE: The manager said that four new staff have been recruited to work at the home. During the inspection these members of staff were reading policies and information with the deputy manager as part of their in-house induction. The manager said that one member of staff has recently left. The shift leader had forgotten that two residents were at college that morning. This caused one resident to become anxious about where and when they were going to college and how they were getting there. Staff calmly spoke to them to relieve their anxieties but in the inspector’s opinion this situation could have been avoided if the morning shift had been organised better. The manager said that three of the staff are currently doing NVQ level 3. The newly recruited staff will be doing NVQ level 2. The manager said that training for staff in adult protection has been booked for November 2005. Staff have not received accredited training in the management of medication. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 42 The health, safety and welfare of residents is not always adequately promoted and protected. EVIDENCE: The cupboard containing cleaning materials was locked so that residents cannot access it and potentially harm themselves. In the kitchen cupboard there were two opened plastic bottles of tomato ketchup. On the bottle it stated, ‘once opened it must be kept refrigerated’. Resident’s records included details of an incident where a resident had been verbally and physically aggressive towards staff resulting in the resident being restrained by staff to help them calm down. This had not been reported to the CSCI as required. The fire records indicated that staff test the fire equipment regularly to make sure it is working. Regular fire drills take place to ensure that residents and staff are aware of the procedure to follow in case of fire. An engineer serviced the fire equipment and staff received training in fire safety in September 2005. One of the resident’s bedroom doors was propped open with a chair. Staff said that the resident often did this but recognised the risks involved. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 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 x 3 x x x Standard No 22 23 Score 2 2 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x 2 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x 2 2 1 x 1 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 2 17 Standard No 31 32 33 34 35 36 Score x x 2 x 2 x CONDUCT AND MANAGEMENT OF THE HOME 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ulysses House Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x DS0000016734.V258030.R01.S.doc Version 5.0 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 YA1 Regulation 4(1) (a, b, c) Requirement Timescale for action 31/07/05 2. YA1 5 The statement of purpose must contain the following information: the name and address of the provider and manager, the details regarding the admission process should be expanded to include the assessment process and if trial visits will be available, the details of how activities are planned, funded, staffed and frequency with which they are undertaken, the complaints procedure must detail that the CSCI can be contacted at any time, the measurement of room sizes, the homes locked door policy. (Previous requirement - timescale 31 May 2005) Not assessed at this inspection. The service users guide 31/07/05 must contain all DS0000016734.V258030.R01.S.doc Version 5.0 Ulysses House Page 23 3. YA5 5(1)(b), 17(2) 4(8) 4. YA17 17 (2), Sch4 (13) 5. YA20 13(2), 18(1)(a) 6. YA42YA20 13 (2) (4) (c) 7. YA22 22(1) (2) 7. YA35YA23 13(6), 18(1)(a,c) elements as listed in standard 1 and regulation 5. (Previous requirement - timescale 31 May 2005). Not assessed at this inspection. Residents individual contracts must be further developed to include the room to be occupied and the fees charged. (Previous requirement - timescale 31 May 2005) Not assessed at this inspection. Records of food provided to each resident must be completed each day. Staff who administer medication to residents must receive accredited training. Evidence that staff have received this training must be available in the home. (Previous timescale of 30th September 2005 not met). The medication cabinet must be secured to the wall. As stated on the ‘Immediate Requirements’ sheet left at the inspection Residents must be informed of the homes complaints procedure, which must include details and the role of the CSCI in dealing with complaints. All staff must be trained in adult protection procedures and a record of the training kept 30/06/05 12/10/05 31/12/05 14/10/05 30/11/05 30/11/05 Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 24 8. YA23 12 (1), 13 (6) 9. YA24 23 (2) (h) 10. YA24 23 (2) (b,c) 11. YA26 16(2)(c) 23(2)(b, d) 23 (2) (b,c,j) 12. YA27 13. YA28 23 (2) (c) 14. YA28YA26 23 (2) (c) including date, duration, title and organising body. (Previous timescales of 31 March, 30 June and 30 September 2005 not met). Records on the use of physical intervention require improvement to ensure they meet the Department of Health guidance for restrictive physical intervention (2002). Appropriate accommodation must be provided for service users who choose to smoke. (Previous timescale of 30 June 2005 not met). The kitchen cupboard must be replaced. (Previous timescale of 31 May 2005 not met). The kitchen drawer must be replaced. The carpet must be replaced in the identified residents bedroom. The WC on the second floor must be unblocked. As stated on the ‘Immediate Requirements’ sheet left at the inspection The aerial lead from the television in the lounge must be secured to the wall. (Previous timescale of 13 May 2005 not met). A connector must be fitted to the television aerial in the identified residents bedroom. 12/10/05 30/11/05 30/11/05 13/11/05 13/10/05 21/10/05 21/10/05 Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 25 15. 16. 17. 18. 19. YA28 YA30 YA30 YA30 YA42 23 (2) (b,d) 23 (2) (c,d) 16(2)(j) 23(2)(c) 16(2)(e) 23(2)(c) 37 20. YA42 13 (4) (c) 21. YA42 23 (4) (a)(c) (i) The office must be redecorated. A new vacuum cleaner must be provided. The dishwasher must be repaired or replaced. The tumble dryer must be repaired or replaced. Any event that affects the well - being of a resident must be reported to the CSCI. As stated on the ‘Immediate requirement’ sheet left at the inspection. Once plastic bottles of tomato ketchup are opened they must be kept refrigerated. As stated on the ‘Immediate Requirement’ sheet left at the inspection. Fire doors must not be propped open. As stated on the ‘Immediate Requirement’ sheet left at the inspection. 31/12/05 21/10/05 31/10/05 30/11/05 12/10/05 12/10/05 12/10/05 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. 2. 3. Refer to Standard YA1 YA8 YA16 Good Practice Recommendations The service users guide should be produced in an accessible format for the residents. Not assessed at this inspection. Minutes should be kept of all residents meetings held in the home. Residents should be involved in doing their own laundry as much as they are able to with support from staff. DS0000016734.V258030.R01.S.doc Version 5.0 Page 26 Ulysses House 4. 5. 6. YA23 YA28 YA33 Inventories of resident’s belongings should be regularly updated. It is recommended that the garden be further developed to increase the use of it by residents. All shift leaders should be aware of resident’s activities for each day and ensure that the resident is aware of and prepared for these. Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 27 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ 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 Ulysses House DS0000016734.V258030.R01.S.doc Version 5.0 Page 28 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!