Inspection on 20/06/05 for Ware Road (49)

This inspection was carried out on 20th June 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 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 12 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Ware Road (49) 26/06/07

Ware Road (49) 14/02/07

Ware Road (49) 25/08/06

Ware Road (49) 18/01/06

Ware Road (49) 21/12/04

Ware Road (49) 16/06/04

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 Ware Road (49) 49 Ware Road Hertford Hertfordshire SG13 7ED Lead Inspector Angela Dalton Unannounced 20 June 2005 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. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Ware Road (49) Address 49 Ware Road, Hertford, Hertfordshire, SG13 7ED 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) 01992 501288 01992 501288 Mencap Frances Croughan CRH Care Home 6 Category(ies) of LD-6, LD(E)-6 registration, with number of places Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 21 December 2005 Brief Description of the Service: 49 Ware Road is a large Victorian house, which has been converted into providing accommodation for six people with a learning disability. The home consists of six single bedrooms, one ground floor shower room with WC, one bathroom, one separate WC, lounge and kitchen diner. It has a small front garden with limited parking. There is a large rear garden. The home is conveniently situated on the main Hertford to Ware road, which can be busy. It is close to the shopping centre of Hertford, with all its facilities and major transport links. The home was first registered 13th November 1991 under the Registered Homes Act (1984). 49 Ware Road is part of Mencap. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced Inspection was conducted by one Inspector between 11am and 4.45pm on 20th July 2005. Overall, a high standard of care was observed to be delivered. Some previous requirements remain relating to décor and recruitment documentation. The Registered Manager has been seconded to a job within the company but the Commission has not been notified. A requirement has been made to ensure that this occurs. What the service does well: What has improved since the last inspection? 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. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 6 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 Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 7 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) 1,2,3,4&5 Established documentation is in place which ensures service users’ needs can be met. EVIDENCE: The acting manager plans to review the Statement of Purpose to ensure that it remains current. Service users each have a copy of the Service User’s Guide which is in a format that can be understood. The service users have all resided in the home for a number of years and as such all documentation is established. Mencap has an assessment process that could be used if a new service user was admitted. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 8 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 Staff are not equipped with comprehensive information to enable challenging behaviour to be managed. Care plans are written in consultation with service users to ensure that their likes and dislikes are identified. EVIDENCE: The home is assisting service users to work upon aspects of their care plan by implementing person centred planning. Using Person Centred Planning is a way of ensuring everything staff do is based upon what is important to a person from their own perspective. Service users are working with staff to ensure that their plan is prepared in a format that can be understood by the individual. One plan has been recorded onto audio tape whereas another consists of photographs. Service users were assisting staff to clear out the shed on the day of inspection. Ware Road is an active house where service users are encouraged to participate in the way in which the home is run. Day to day tasks such as posting letters and cooking is done with service users or with them present if they do not wish to participate. Regular house meetings take place to review individual contributions. A requirement has been made to ensure that a care plan is in place to monitor and manage challenging behaviour. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 9 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) 11,12,13,14,15,16&17 Service users benefit from a range of activities. Refrigerated food is poorly stored exposing service users to potential risk. EVIDENCE: Some of the service users have been away on holiday and others are due to go. They have chosen their destination and whom they wish to go on holiday with. Some service users attend day services but activities form part of the daily routine. A computer is available for service users to use and individual bedrooms are equipped with televisions and stereos. Families appear to have a close relationship with the home and staff work closely to ensure that regular contact is achieved. A record of menus is kept. A requirement has been made to ensure that food stored in the fridge is dated on opening and stored appropriately. Ham and other perishable foods were left open in the fridge. A recommendation has been made for service users who constantly help themselves to food to be provided with an individual supply of healthy alternatives. Dietetic support should be sought if necessary. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 10 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 The privacy and dignity of service users is not observed by visiting professionals. EVIDENCE: A requirement has again been made to ensure that chiropody visits take place in private. If service users wish to be seen together then this must be documented. Overall, service users individual wishes are observed and reflected within their care plans. The Inspector observed staff interacting with service users to ensure that choices are given and met. Staff were able to meet immediate needs and pick up on cues because they know service users well. Overall, medication was kept in good order. A requirement has been made to ensure that it is stored at the correct temperature. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 11 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 A complaint procedure is in place. Service users are not adequately protected from financial abuse. EVIDENCE: Policies and procedures that affect service users are translated into pictorial form (Widget). This enables service users to have an awareness of issues that are appropriate. Service users have a key member of staff so that they are able to share any concerns and feel listened to. Regular team house meetings also occur to enable service users to air their views. A requirement has been made to ensure that service users are protected by the internal transport policy. If service users travel with staff in their private car they are invoiced and charged for mileage. The home has a mini bus but not all staff drive this. Service users are open to potential exploitation if staff use their cars in preference to the home’s minibus. Service users have individual cash tins bolted to bottom drawers of individual wardrobes. Two tins were checked during the inspection. It is recommended that the balance be checked on regular basis by staff and recorded, as this is not currently occurring. The Acting Manager is in the process of introducing new bedroom furniture with more easily accessible locked drawers. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 12 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) 24,25,26,27,28,29&30 Areas of the home are unclean and not well maintained. EVIDENCE: Ware Road is an old building and needs regular maintenance. Areas of the home require thorough cleaning specifically the bathroom and kitchen. Décor in the bathroom has still not been fully completed. The bath panel is pitted and the paint is peeling. A tread on the stairs is cracked and unsafe. In the kitchen kick board plinths are loose and the flooring does not meet the edge of the cupboards. The laundry was unclean. The home is shabby and furnishings are worn in some areas. The monthly reports conducted by the proprietor’s representative do not reflect the Inspector’s findings. There are plans to redecorate the lounge and paint samples were on the wall to canvas service users’ opinions on colour. Furniture is going to be repaired and the settees are to be re-covered. Requirements have been made to address the cleanliness and décor in the home. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 13 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 Service users are not adequately protected by comprehensive recruitment checks. Staff are at risk of burning out because of the length of the working week. EVIDENCE: The Deputy Manager is currently Acting Manager as the Registered Manager has been seconded within the company. A requirement has been made to notify the Commission formally of the change in the home’s management. Regular training is offered to the staff team and this was evident on the personnel files. A requirement has again been made to ensure that references are kept on file within the home. Criminal Record Bureau checks must be evidenced for visiting professionals who work unsupervised with service users. A recommendation has been made to review the number of shifts worked. Staff regularly work a ‘run’ of eight days in a row without a day off. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 14 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) 37,3,39&40 The health and safety of service users is not protected within the home. EVIDENCE: Although there have been changes within the management team service users and staff are familiar with the staff who have been given increased responsibilities. Several issues were identified during the inspection as posing a risk to service users. A tread is cracked (almost to breaking point) on the stairs; door wedges are in place on several doors and in the event of a fire service users would not be protected; a hand rail is loose on the stairs; Cleaning fluids and insecticide were in an unlocked cupboard. A requirement has been made to ensure the health and safety of service users is maintained. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 15 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 3 3 1 3 3 2 Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 2 Standard No 31 32 33 34 35 36 Score 3 3 2 2 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ware Road (49) Score 3 2 2 3 Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 2 3 I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 16 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 YA6 Regulation 12(1)(b) Requirement Care Plans must be in place to monitor and manage challenging behaviour displayed by service users. Refrigerated food must be stored appropriately. Visits to service users from medical/healthcare professionals must take place in private THIS REQUIREMENT WAS MADE AT THE PREVIOUS INSPECTION Medication storage temperatures must be recorded. Service users must be protected from financial abuse. A protocol must be devised to illustrate milege charges to service users and when staff are able to use their cars to transport service users. The home must be well maintained: the stair tread must be fixed, the loose handrail must be secured, the kitchen floor and kitchen plinths must be made good. The decoration in the bathroom must be completed to a satisfactory standard. It has previously been partially decorated and the paint is Timescale for action 30/09/05 2. 3. YA17 YA19 13(4)(c) 14(4)(a) 31/07/05 31/07/05 4. 5. YA20 YA23 13(2) 13(6) 31/07/05 12/08/05 6. YA24 23(2)(b) 31/08/05 7. YA27 23(2)(d) 30/09/05 Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 17 8. YA30 23(2)(d) 9. YA34 17 (2) Schedule 4 10. YA34 19(1)(b) Schedule 2 38(2) 13(4)(c) 11. 12. YA37 YA42 peeling. THIS REQUIREMENT HAS BEEN MADE ON TWO PREVIOUS OCCASIONS. FAILURE TO OBSERVE THE REQUIREMENT WILL RESULT IN AN ENFORCEMENT NOTICE BEING SERVED. THe home must be thoroughly cleaned: The bathroom, kitchen and laundry require particular attention. All references pertaining to staff must be kept in the home. THIS REQUIREMENT HAS BEEN MADE AT THE PREVIOUS INSPECTION. FAILURE TO OBSERVE THE REQUIREMENT WILL RESULT IN AN ENFORCEMENT NOTICE WILL BE SERVED IF Visting Professionals who work unsupervised with service users must provide the home with evidence of a Criminal Record Bureau disclosure. The Commission must be notified of the secondment of the home manager. The health and safety of service users must be ensured. A safe alternative to door wedges must be employed. The cracked stair tread and loose hand rail must be made safe. COSHH agents must be securely stored. 31/08/05 31/07/05 31/08/05 31/07/05 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. Refer to Standard YA17 YA33 Good Practice Recommendations Healthy alternatives should be provided to service users with challenging behaviour related to food. The advice of a dietician should be sought where necessary. The staff rota should be reviewed to ensure that no longer I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 18 Ware Road (49) 3. YA42 than five days in a row are worked. Hot water temperatures should be more regularly recorded than once a month. Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City, Herts 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. Extracts may not be used or reproduced without the express permission of CSCI Ware Road (49) I52 s19608 Ware Road v239059 200705 Stage 4.doc Version 1.40 Page 20 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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