Inspection on 25/08/06 for Ware Road (49)

This inspection was carried out on 25th August 2006.

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 no outstanding requirements from the previous inspection report, but made 2 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) 18/01/06

Ware Road (49) 20/06/05

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 Marian Byrne Key Unannounced Inspection 25th August 2006 10:00 Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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 Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ware Road (49) Address 49 Ware Road Hertford Hertfordshire SG13 7ED 01992 501288 01992 501288 FP 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) www.mencap.org.uk Royal Mencap Society Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th January 2006 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) DS0000019608.V306638.R01.S.doc Version 5.2 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 3pm on 25th August 2006. It was a positive inspection with many of the previous requirements being met. The acting manager continues to work hard with the staff team to improve the lives of the service users. A new manager has been appointed but will be on maternity leave until April 2007. The registered providers must ensure that the deputy manager is fully supported in a role that she now has occupied and will continue to occupy for over a year. The service users who reside at Ware Road remain unchanged they were friendly and chatty with the inspector. What the service does well: What has improved since the last inspection? What they could do better: The home while generally clean and odour free there were areas of the home that were shabby and needed to be cleaned. The staffing arrangements have not been reviewed as demanded by a requirement left at the last inspection. Care staff are expected to clean the home as well as care for the service users this is clearly not working. While staff were able to inform the inspector of the activities the service users engage in there was no formal activities agenda and activities appeared to be as and when rather that a formulated part of person centred care plans. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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 Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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): No new service users have been admitted for several years. EVIDENCE: Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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): 6,7,9. Care plans reflect the needs of the service users. Service users are involved in decisions making and are supported in risk taking in all aspects of their lives. Quality in this outcome is adequate; this judgement has been made using available evidence including a visit to this service. EVIDENCE: This home is unusual in that there has not been a new admission since the early nineties. Staff know the service users very well. The care plans reflect this. Staff have a casual approach to activities and appear to fit them into the running of the home rather than the other way around. However service users appear to have an active social life. To ensure that person centred care is fully implemented staff must be more aware of the need to structure the day in the home around the activities of the service users. They may be prevented from carrying this out due to the ratio of staff to service users. Service users are facilitated to take risks. One service user likes to wear bulky slippers there was no risk assessment available to ensure all obvious dangers were identified and where possible reduced or eliminated. Another service user like to use the Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 10 swing in the garden an injury reducing area has been laid under the swing area. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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, Service users have a full and active life. They live in an environment where they are respected. A nutritious and varied diet is offered. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service EVIDENCE: As stated previously service users lead a full and active life. Staff were observed to be very respectful to the service users and there was obvious affection between staff and the service users. Service users are where possible encouraged to fulfil their dreams and ambitions. This may be inhibited by the staffing ratios. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 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 the following standard(s): 18,19,20. Service users receive personal care in a way they prefer. Emotional and physical needs are met. Administration of medication is carried out appropriately. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service. EVIDENCE: Due to the fact that there has been no change in the service users and that there is a core of permanent staff that has not changed in many years staff know the service users well and are able to understand them very well. None of the service users administered their own medication. The home had an appropriate medication policy in place. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 13 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. Service users are listened to and protected. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service EVIDENCE: As previously stated in this report service users are listened to and acted on. All service users are protected from abuse, there was not evidence of neglect. Protection of vulnerable adults training is booked for mid October 2006. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 14 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): 24,30. The home is decorated and furnished in a pleasant domestic manner. The level of cleanliness in the home must improve. Quality in this outcome is poor; it would have been good if the level of cleanliness was improved; this judgement has been made using available evidence including a visit to this service EVIDENCE: The level of cleanliness in the home must be improved. Two bedrooms were less than clean carpets were stained. The décor in the sitting rooms and the other communal areas was domestic in style the furniture was comfortable and stylish. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 15 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): 32,33,34,35. Care staff were considered to be competent and qualified. Staff were recruited under the home’s policy an procedures. Staff were trained to meet the needs of the service users. Quality in this outcome is adequate; this judgement has been made using available evidence including a visit to this service EVIDENCE: The home requires a review of staffing levels as the needs of service users have changed since the home first opened. This requirement was made at the last inspection. The registered provider should also review the cleaning in the home. Evidence is required to show how eight staff meet the twenty-four hour requirements of the home and accommodate staff training, sickness and holidays. The deputy manager also works shifts which compromises the time spent on management tasks. All required recruitment documentation was in place. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 16 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): 37,39,42. Service users views are underpin the running of the home. The health and safety of service users must be underpinned by robust risk assessments. Quality in this outcome is good; this judgement has been made using available evidence including a visit to this service EVIDENCE: A new manager has been appointed but will not take up post until April 2007. this leaves the home without a Registered Manager until then. The deputy manger is taking responsibility for the management of the home, it wasn’t clear how she is being supported by the Registered Provider. The home has been without a Registered Manager for almost a year. The staffing numbers in the home must be reviewed this included the cleaning of the home. Robust risk assessments must take place where service users are being facilitated to make decisions that contain an element of risk. This includes wearing footwear that could cause the service user to have an accident. Where possible risks must be Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 17 identified, reduced or eliminated to ensure the service users has as much freedom of choice as possible. Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 18 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 CONCERNS AND COMPLAINTS CHOICE OF HOME Standard No Score 1 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score Standard No 22 23 Score 3 3 3 3 X 2 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 2 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000019608.V306638.R01.S.doc LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ware Road (49) Score 3 3 3 x 2 X X X X 3 X Version 5.2 Page 19 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 YA 9 Regulation 12 & 13(4) Requirement Footwear of choice must be risk assessed to ensure freedom of choice and safety of service users. The Commission must be notified of reviewed arrangements regarding the management of the home. Once determined an application to register the manager must be submitted. Staffing levels must be adequate for the needs of service users. Evidence must be provided to CSCI to demonstrate how eight staff meet the needs of six service users whilst ensuring training, holidays, sickness, supervision and management are covered. Rotas must be submitted as supporting documentation. This includes cleaning of the home. Timescale for action 25/08/06 2. YA37 38(2) 30/09/06 3. YA33 18(1)(a) 30/09/06 Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 20 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 YA30 Good Practice Recommendations The level of cleaning in the home should be improved Ware Road (49) DS0000019608.V306638.R01.S.doc Version 5.2 Page 21 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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