Inspection on 13/12/05 for Vicarage Road (62)

This inspection was carried out on 13th December 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 10 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Vicarage Road (62) 04/08/09

Vicarage Road (62) 06/08/07

Vicarage Road (62) 08/06/05

Vicarage Road (62) 27/01/05

Vicarage Road (62) 23/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Vicarage Road (62) 62 Vicarage Road Buntingford Hertfordshire SG9 9BA Lead Inspector Angela Dalton Unannounced Inspection 13th December 2005 11:00 Vicarage Road (62) DS0000019603.V268869.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 Vicarage Road (62) DS0000019603.V268869.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. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Vicarage Road (62) Address 62 Vicarage Road Buntingford Hertfordshire SG9 9BA 01763 273191 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) Granta Housing Society Limited Kim Taylor Care Home 4 Category(ies) of Learning disability (4), Learning disability over registration, with number 65 years of age (4) of places Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th June 2005 Brief Description of the Service: Vicarage Road is part of Granta Housing Association Ltd. The home is situated at the end of a cul-de-sac in a quiet residential area of Buntingford and within walking distance of the town centre. The ground floor consists of a lounge with dining area, a kitchen with breakfast area, a utility room, one single bedroom and a W.C. A stair lift has been installed. The first floor comprises three single bedrooms, bathroom and toilet. There is a small office that is also used as the staff sleeping in room. To the front is a large driveway to the home where the home’s vehicle is parked and a small well tended garden. There is a larger garden to the rear of the property. The home is registered for 4 service users with a learning disability including those over 65 years of age. Vicarage Road was first registered 2nd September 1993 under the Registered Homes Act 1984. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector conducted this unannounced inspection on 13th December 2005 between 10am and 2.50pm. Progress regarding requirements made at the previous inspection was reviewed. There is currently one service user vacancy within the home but the core group of service users remains unchanged. Christmas preparations were being made and service users stated they were looking forward to this event. The care provided continues to be of a high standard. Service users are encouraged to be independent and assessed risks are taken as part of this process. A new shower room has replaced the inaccessible bath and despite teething problems service users said that they found it easier to use. Two service users were at home during the inspection. What the service does well: What has improved since the last inspection? What they could do better: The hot water supply to the new shower runs out after three minutes. Although the shower is easier to use all service users must sit down as the shower rail is too short to stand up. The shower chair is too close to the door resulting in service users sitting in an uncomfortable position. The hot water supply was an issue at the previous inspection. A lock is needed on the medication fridge, as there is an unsuitable childproof lock currently in place. Other medication issues require addressing. Specific training would benefit staff e.g. diabetes to enable service users to be assisted with health requirements. Home’s Statement of Purpose has yet to be updated as have the way in which complaints are recorded. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 6 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. Vicarage Road (62) DS0000019603.V268869.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 Vicarage Road (62) DS0000019603.V268869.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): 1,2,4 Inadequate information is available to service users and staff which does not facilitate informed choices to be made. EVIDENCE: The Statement of Purpose is in place but is not in a format that is appropriate to meet service users needs. The previous recommendation to update the information to include reference to the smoking policy remains unmet. A prospective service user was visiting for the first time later on the day of Inspection. An assessment had not been conducted to ensure that staff were able to support them, and existing service users during this visit. The spare room is currently being used as additional office space. Service users were aware of the ‘tea visit’ and stated that they felt involved and would be able to offer their opinion on the success of the visit. Vicarage Road (62) DS0000019603.V268869.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 Information is not available to ensure service users’ health needs are met. EVIDENCE: Care plans illustrated that service users were involved in developing their own plans of care and they were regularly reviewed. It was noted that recent changes in health had not been recorded with an associated care plan. Staff had received no training regarding diabetes but had been given some information from a health professional. A requirement has been made to ensure documentation is available to enable staff to support service users to meet their health needs. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 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 the following standard(s): EVIDENCE: Not inspected on this occasion. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 11 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): 19,20,21 Health needs are not fully met. Service users safety is not assured through unsafe medication practises. Funeral wishes are reflected in individual care plans. EVIDENCE: As stated earlier no evidence was in place to illustrate how a service user who has developed diabetes is to be supported and their health maintained. Staff have not received training and there was no evidence to show that all staff were aware of changes in diet and health requirements. The medication system has improved but some more progress is needed. The childproof lock attached to the medication fridge is inadequate. Creams are overstocked. Medication temperatures are not being recorded for the drugs fridge and are incorrectly recorded for the medication cupboard. There is still no system for recording the use or amounts of PRN (as required) medication. Funeral wishes are recorded and personal wishes are clearly documented which leaves staff in no doubt as to what each service users’ requirements are. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 12 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 The home does not follow a comprehensive complaints procedure. EVIDENCE: The complaints process does not illustrate how complaints are investigated and concluded. Although complaints that are recorded are historical in origin there is no format for complaints to be explored and the route to the outcome is not noted. The only change that has occurred since the previous inspection is that three columns have been drawn onto one page of the complaints book. A recommendation has again been made. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 13 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): 24,26,27,29,30 Décor within the home requires updating. Personal care needs are affected by the hot water supply within the home. EVIDENCE: Service users live in a homely and personalised environment. It was odour free but there are areas of the home where the décor looks weary. A bedroom carpet was worn and stained. A requirement has been made to submit a maintenance plan to the Commission. A shower has been fitted to replace the bath that proved difficult for service users to access. The shower is fitted to a short rail that does not enable service users to stand at full height. Staff reported that the supply of hot water ran out before the completion of a shower and they were conserving the supply by switching the water off at intervals during the shower. This must be addressed. There are plans to replace the shower chair as it is currently fitted too close to the shower door and service users have to sit at the wrong angle to prevent their knees being injured. The inspector recommends that the services of an Occupational Therapist are secured to ensure the correct alterations are made. Service users who have a television in their rooms are not able to watch it as they are awaiting TV licences to arrive. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 14 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): 34 Service users are protected by the home’s recruitment policies. EVIDENCE: Improvements have been made since the previous inspection. All required documentation was in place. This evidences that measures are taken to ensure that vulnerable service users are protected. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 15 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): The home lacks a permanent manager. EVIDENCE: The acting manager has been asked by the area manager to apply for registration with the Commission for Social Care Inspection. The current registered manager remains on long term sick. A requirement has been made for the application to be submitted by the end of January 2006. Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 16 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 2 X 3 X Standard No 22 23 Score 2 X ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 2 X X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 2 X 2 X X 2 2 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X X 3 X X CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Vicarage Road (62) Score X 2 2 3 Standard No 37 38 39 40 41 42 43 Score 2 X X X X 2 X DS0000019603.V268869.R01.S.doc Version 5.0 Page 17 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 2 Standard YA2 YA2YA19 Regulation 14 15 Requirement An assessment must be in place for any prospective service user. Healthcare requirements must be reflected in the care plan. Staff must be equipped to meet individuals’ needs e.g. diabetes The childproof lock attached to the medication fridge is inadequate. Creams are overstocked. Medication temperatures are not being recorded for the drugs fridge and are incorrectly recorded for the medication cupboard. There is still no system for recording the use or amounts of PRN (as required) medication. A requirement regarding medication was made at the previous inspection. The décor and furniture and fittings within the home require renewal. Attention to bedroom carpets is needed as they are stained and worn. A maintenance plan is required to evidence the schedule for the coming year. Sufficient hot water must be available to enable service users DS0000019603.V268869.R01.S.doc Timescale for action 31/12/05 31/01/06 3 YA20 13(2) 31/12/05 4 YA24YA30 23 31/01/05 5 YA27YA42 23& 13(4) 16/12/05 Vicarage Road (62) Version 5.0 Page 18 6 7 YA29 YA37 23 8 to shower. Although the problem identified at the previous inspection has been addressed there is still an issue with the hot water supply. The shower must be suitable for the needs of independent and dependent service users. An application to register the manager with the Commission for Social Care Inspection must be received. 31/01/06 31/01/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The Statement of Purpose should be reviewed to ensure it is service user friendly in a format that can be understood. The homes smoking policy should be incorporated and the Commissions details updated. Records of complaints investigations, how they were conducted and how the conclusion was reached should be kept. Staff should ensure that a current TV licence is in place for all service users with their own television. 2 3 YA22 YA26 Vicarage Road (62) DS0000019603.V268869.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ 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. 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