Inspection on 04/05/05 for Urmston House

This inspection was carried out on 4th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Urmston House 27/09/06

Urmston House 18/10/05

Urmston House 05/11/04

Urmston House 11/05/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Urmston House Hareclive Road Hartcliffe Bristol BS13 0LU Lead Inspector Helen Taylor Announced 04 May 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. Urmston House Version 1.10 Page 3 SERVICE INFORMATION Name of service Urmston House Address Hareclive Road Hartcliffe Bristol BS13 0LU 0117 9642616 0117 9642662 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) Shaw Healthcare Specialist Services Ltd To be appointed Care home with nursing 5 Category(ies) of LD Learning disability registration, with number of places Urmston House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Staffing notice dated 13/09/2000 applies. Manager must be an RN on parts 5 or 14 of the NMC register. Date of last inspection 5th November 2004 (Unannounced) Brief Description of the Service: Urmston House is a purpose built residential care home registered with the Commission for Social Care Inspection to provide nursing care for 5 people with a learning disability in the age range 18 to 65 years. The home is owned and operated by Shaw Care Ltd, a subsiduary of Shaw Homes, and was established to provide person centred care for adults with special needs in the community. The property is situated in a residential suburb of Bristol with local shops and amenities close by. Accommodation is arranged over two floors. The upper floor of the accommodation is office and staff facilties. There are five single bedrooms, all with en-suite bathrooms, and kitchen facilties. Each room has individual access to the garden area. Communal facilites include a lounge, snoozelon/therapy room, and a hot tub room. The home provides nursing care for five people with complex health and communication needs. Urmston House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection conducted as part of the annual inspection process to examine the care provided, and monitor the progress in relation to requirements and recommendations from the last inspection conducted in November 2004. The inspection took place over 5 hours. During the process interactions between the staff and residents were observed. Three staff members and the manager were spoken to. A pre-inspection questionnaire and four comment cards provided information relevant to the inspection. The Inspector looked around some of the building. The following records were examined: • A sample of care files and associated information • Fire safety records • Recruitment information • Staff supervision records • Maintenance book • Administration of medication What the service does well: What has improved since the last inspection? The management team have taken action to minimise the presence of odours in the home. New flooring has been laid, and one apartment and the hallway have been re-decorated. For residents with a sensory impairment the home provides a variety of aids and adaptations to meet individual need. Many of the tactile/textured symbols have been renewed during the re-decoration process. A special light fitting has been installed in one resident’s room after he indicated a preference for it, and it was noted to have a calming effect during personal time. Urmston House Version 1.10 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Urmston House Version 1.10 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 Urmston House Version 1.10 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. There is a consistent care planning system in place to adequately provide staff with the information they need to satisfactorily meet residents’ needs. The staff team have the skills necessary to communicate effectively with the residents, using their preferred mode of communication. The home is able to deliver services, which focus on the needs and choices of the residents. EVIDENCE: The care plan is organised in three separate files, each with a specific purpose. The main file contains monthly audits of care, risk assessments and monthly reviews of service provision. The working file contains the care plan, daily observation records and key work meetings. A file with detailed support guidance indicates the resident’s likes and dislikes in relation to all aspects of daily living. The records reviewed were detailed and included behaviour management strategies. The staff team were observed providing individualised sensitive care. A staff member spoken with explained joint working with the Community Learning Disability Team ensured the needs of the residents were being met with a consistent approach from the key team. Urmston House Version 1.10 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 standard(s) 6,7,8,9,10. The assessment and care planning processes ensure all aspects of personal, social and healthcare needs are met. The key team system promotes individual choice and enables residents to make decisions about their lives. EVIDENCE: Each resident has an allocated key team, led by a team leader, who provides the day-to-day care provision. The care plan and associated documentation are held in the resident’s own room, and are shared with the resident by members of the key team. A stable staff team enables positive relationships to be developed, which ensures staff members are able to use complex communication methods to determine the likes, choices and needs of the residents. Support guidance for day to day functioning, and associated risk assessments provide detailed guidance for staff providing care. The records reviewed were written in appropriate language and were up to date and in order. Urmston House Version 1.10 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,13,14,16,17. Opportunities for personal development and links with the local community are an integral part of the care provided at this home. The key team system provides a variety of evidence that residents’ views are sought and acted upon. The home offers a variety of home cooked meals meeting the nutritional and special dietary requirements of the residents. EVIDENCE: Opportunity plans developed in consultation with the residents encourage the pursuit of interests in and outside of the home. One staff member spoken with confirmed the plans are reviewed to reflect the resident’s likes and dislikes. The care plans and daily recordings indicated a high level of interaction between the staff and residents. Outings in the community are monitored as part of the monthly care plan review system. This is consistent with good practice. There was some evidence that staff members had tried to plan an annual holiday for one resident. Each resident should have the opportunity of an annual seven-day holiday, or a series of short breaks, away from the home. Urmston House Version 1.10 Page 11 The organisation need to develop a central database providing guidance to staff members tasked with organising annual holidays for residents. There was little evidence that suitable or appropriate destinations, with accommodation to meet the needs of the residents had been resourced. Menus were included as part of the pre-inspection information received. The cook confirmed the menus were varied and catered for special diets. Information from key workers ensured the likes and dislikes of the residents were clearly noted in the care plans, and this was reflected in menu planning. The cook confirmed a high level of home cooking, with fresh meat and vegetables and home baked cakes. The cook demonstrated a good understanding of the needs of the residents, and ensured all records required by legislation were up to date and in order. The kitchen was clean and well organised. Urmston House Version 1.10 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18,19,20,21. Personal support was offered in such a way as to promote and protect the residents’ privacy and dignity. The procedures for the administration of medication were well managed minimising the risk to residents. The home has made progress in ensuring the residents’ wishes are upheld in the event of a death in the home. EVIDENCE: A sample of care files were reviewed and provided evidence that personal support and intimate care is provided with the residents preferences recorded as an integral part of the care provision. Guidance in relation to personal hygiene, clothing, hairstyles and choice in relation to personal items in the rooms was evident. The staff present demonstrated an enthusiastic, sensitive approach to the residents, and were observed interacting and supporting residents in their preferred routines. The staff team were adhering to policies and procedures in place for the safe administration of medication. A review during the inspection revealed no errors. The medication was appropriately stored and was well organised. All medication records were up to date and in order. The staff member coUrmston House Version 1.10 Page 13 ordinating the storage of medication demonstrated a good understanding of the task. A weekly audit ensured risks were minimised. The residents accommodated have complex communication needs and it has been difficult to ascertain their views and wishes in the event of death. The home have made progress and now include this as part of the overall care planning process. Two comment cards received from visiting professionals indicated good communication with the home. One professional commented on the high level of commitment from the staff team, who delivered a high standard of care to the residents. Urmston House Version 1.10 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23. The complaints process in the home is good and there was evidence that the residents’ views are listened to and acted upon. The risk of residents suffering any form of abuse or neglect is appropriately minimised. EVIDENCE: A detailed complaints procedure is in place. A review of the care file information and discussion with staff provided evidence that the resident’s views form an integral part of the care plan. Key team meetings are held on a regular basis to review and develop care provision to meet the needs, choices, and preferences of the residents. Policies and procedures are in place to ensure residents are protected from any form of abuse. Staff training in relation to abuse awareness is held on a regular basis and forms part of the mandatory training for all new staff. One staff member progressing through the Learning Disability Award Framework induction programme confirmed a raised awareness about the issues of protection. This is consistent with good practice. Urmston House Version 1.10 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,28,29,30. The standard of the environment in this home is good, providing residents with a safe, homely place to live. EVIDENCE: The home is purpose built and each resident has a ground floor room with ensuite bathing and kitchen facilities. Each room has been adapted to suit the needs of the resident being accommodated, with the provision of assisted bathing, sensory adaptations and equipment as deemed necessary through the assessment process. The furniture and fittings were domestic in style. The communal space consists of a large lounge, a sensory/snozelon room, and a hydrotherapy pool. A laundry room is also available, and residents are supported when using this. A requirement from the last inspection in relation to an odour in the home has been complied with. New flooring has been laid, and some areas of the home have been newly decorated. There were no odours during this inspection process. Urmston House Version 1.10 Page 16 There were good systems to ensure the upkeep and maintenance of the home, and a person attended two days per week to carry out minor repairs or alterations. A record was kept which indicated staff members had a good awareness of issues in the environment, and were proactive in reporting minor problems. A recommendation was made to include a date when any repair or alteration was completed. This would enable the manager to monitor timescales and ensure prompt attention at all times. During the inspection process external contractors attended to review the garden area. The manager explained there was plans to develop a sensory garden with raised flowerbeds, and to re-design the patio area ensuring it was safe and accessible for all residents. The garden area was drab and unattractive, with little or no appropriate furniture to encourage use by the residents. Improvements in the garden area would enhance the lives of the residents and provide staff with a further venue where activities could take place. Urmston House Version 1.10 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36. The relationships between staff and residents are good and this creates a warm, supportive environment in which the residents’ quality of life is improved. EVIDENCE: Records reviewed provided evidence that a robust recruitment procedure was in place at the home. Staff members spoken with demonstrated a good understanding of their role and responsibilities within the team. Knowledge of the key team system and attendance at care plan reviews was also confirmed. The manager provides support and regular supervision was appropriately recorded. The manager monitors supervision provided by team leaders to support workers closely. This is consistent with good practice. The organisation has developed a comprehensive induction and training programme for all staff. A Learning Disability Award Framework induction package is in use at the home. Staff members then progress to the NVQ in Care. One staff member told the Inspector the LDAF training had helped her Urmston House Version 1.10 Page 18 considerably in clarifying her role and raising awareness and understanding of specific conditions related to learning disabilities. A regional training and development officer organises training events, which focus on specific needs: for example, a programme of up-dates on the administration of medication was displayed on the office notice board. Training in Positive Response Techniques was also avaible to staff. This is consistent with good practice. Urmston House Version 1.10 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 37,38,39,40,42,43. The home is well managed ensuring residents interests are promoted and protected by a confident, supported staff team. EVIDENCE: Miss Carolyn Booth is the acting manager. An application for registered manager status is being processed by the CSCI. Miss Booth is currently progressing through the NVQ level 4 and registered manager award. Observation, discussion with staff and a review of records, indicated staff were supported in their role, and the style of management was open and inclusive. Two staff members were designated Health and Safety representatives for the home, and received appropriate training. A review of fire safety records revealed comprehensive information providing detailed information in relation to individual residents needs in the event of an emergency. This was commendable practice. Health and safety meetings were held on a regular basis to ensure any issues were dealt with quickly. Urmston House Version 1.10 Page 20 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 2 3 3 Standard No 11 3 Standard No 31 32 33 Score 3 3 3 Page 21 Urmston House Version 1.10 12 13 14 15 16 17 x 3 3 x 3 4 34 35 36 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 4 3 3 Urmston House Version 1.10 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. Refer to Standard 14 24 28 Good Practice Recommendations To provide each resdient the opportunity of an annuall holiday or a series of short breaks away from the home. Include in the maintenance record a date and signature when each task was completed. Improve the garden area and provide appropriate garden furniture. Urmston House Version 1.10 Page 23 Commission for Social Care Inspection 300 Aztec West Almondsbury South Gloucestershire 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 Urmston House Version 1.10 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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!