CARE HOME ADULTS 18-65
Ware Street Resource Centre 5 Ware Street Tilery Estate Stockton-on-Tees TS20 2BA Lead Inspector
Julia Connor Unannounced 1 September 2005 09:50 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 Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Ware Street Resource Centre Address 5 Ware Street Tilery Estate Stockton-on-Tees TS20 2BA 01642 528136 01642 528139 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) Stockton-on-Tees Borough Council Miss Barbara Moir Care Home 15 Category(ies) of MD Mental Disorder (15) registration, with number of places Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 8th & 19th October 2004 Brief Description of the Service: Ware Street Resource Centre is a purpose built home providing residential care for 15 people with mental health problems. The home also provides a day service and a new addition to the home is a 3 bedded cirsis unit. The home offers a community link group which is a sessional service offering support, a limited skills development service and outreach service as well as having selfcontained residential care and semi-independent rehabilitative accommodation. The home is managed by Stockton-on-Tees Borough Council. Each bedroom is a minimum of 10 sq. m. Ware Street is close to local shops and amenities. There is a small car park at the side of the home. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The inspection commenced at 9.50 a.m. and concluded at 3.20 p.m. Four Residents, two visitors and two members of staff were spoken to during the inspection. What the service does well:
Many of the staff have worked at the home for some time and have a good knowledge of the Residents they care for. One Resident informed the Inspector that he had been at the home for a couple of months and found it suited his needs. He stated that the staff were very good and they sat and talked with him and encouraged him to be as independent as possible. He stated that he went for walks and attended a day centre. He stated that if he had any concerns he would speak to his key worker or the Manager. He stated that the best thing about the home was that he did not have to fight his illness on his own, the staff were there to help him in any way they could. A second Resident stated that the staff were excellent and very approachable. He stated that he was on the independent unit and therefore he shopped and prepared his own meals etc. He stated that he attended a day centre, which he found beneficial. Another Resident stated that the staff were lovely and were always available to talk to, and she was always treated as an individual and had been fully involved in her admission to the home. She stated that her visitors were always made to feel welcome; no matter what time of the day they arrived. This Resident went onto say that she was given lots of support by the staff and that she thought the home was well run. Visitors who spoke to the Inspector stated that they had peace of mind knowing that their relative was living in the home and being cared for by such kind staff. And they knew that the staff would keep them informed of their relative’s progress. The Resident informed the Inspector that she felt safe living in the home and that the staff always listened to what she had to say. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 6 What has improved since the last inspection? What they could do better:
The window in the upstairs non-smoking lounge has flaking paint and must be re-decorated. The wallpaper and border in the upstairs non-smoking lounge is coming away from the wall in places. This must be adequately re-attached or the room redecorated. The ceiling in kitchen 3 is patchy and must be re-decorated. The roof in the conservatory has moved causing leaks during adverse weather. This must be remedied and repaired. The windowsills in the conservatory have flaking paint and must be redecorated. The two external fire exit doors have flaking paint and must be re-decorated. The wood frame of the external garden door is rotting and must be replaced. The paving at the front of the home is uneven and if not attended to will become a tripping hazard for Residents’, visitors, and staff. The up stairs fire door has flaking wood and requires attention to prevent it being compromised. Due to the visitors toilet having no window to open an extractor fan is required. The Registered Manager must ensure that 50 of the care staff has an NVQ Level 2 by 2005 Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 7 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 Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 8 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 Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 9 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 and 2 Prospective Residents’ have the information they need to make an informed choice of where to live. And their needs are assessed prior to admission. EVIDENCE: The home has a statement of purpose and a Service User Guide, which can be accessed by anyone who wishes to know what facilities and services the home offers. The two Residents’ files audited showed that, prior to admission, prospective Residents’ underwent a comprehensive and detailed assessment. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 10 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 and 9 Residents’ know that their changing needs and personal goals are reflected in their individual plan. Residents make decisions about their lives. And are supported to take risks as part of an independent lifestyle. EVIDENCE: Two Residents files were audited and contained an adequate amount of information. It was evident from talking to the Residents and staff that the Residents’ were encouraged to make their own decisions about their life style, which included taking risks. Care plans and risk assessments had been signed by the Resident and their key worker. Residents confirmed during interview with the Inspector that they had participated in the planning and review of their care. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 standard(s) 11, 13 and 17. Residents’ have opportunities for personal development and are part of the local community. Residents’ shop for, prepare and cook their own food. EVIDENCE: Residents’ who spoke to the Inspector stated that there was opportunity for personal development, for example there were day services that offered classes in relaxation techniques, assertive therapy, gardening and home economics. Some Residents attended college for a computer course. Residents’ also stated that they accessed local facilities for example the local sports facilities for badminton and swimming. All of the Residents’ who live at the home shop for and prepare their own meals. The amount of support and guidance from the staff depends on the individual Resident’s level of independence. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 and 19 Residents receive personal support in the way they prefer and their physical and emotional needs are met. EVIDENCE: The Residents’ who spoke to the Inspector were happy with the personal support they received from the staff. The Residents’ and visitors’ spoke highly of the staff. The Residents’ who spoke to the Inspector stated that the staff were always available to talk to and would give support and advice but still encouraged the Resident to make his/her own decisions. The visitors’ who spoke to the Inspector stated that they had peace of mind knowing that the staff knew their relative well enough to know when extra support was required; their relative confirmed this. There was evidence within the Residents care documentation that showed the Residents health care needs were met. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 standard(s) 22 and 23 Residents feel that their views are listened to and acted upon. Staff are aware of the action to take should a complaint or allegation of abuse be made. EVIDENCE: The Residents’ who spoke to the Inspector stated that they had never made a complaint but were confident that if they did so they would be listened to and the appropriate action taken. There is a policy and procedure for the staff to follow should they receive a complaint. There is a policy and procedure for dealing with allegations of abuse. The home also has a copy of the Teeswide Guidance for the protection of Vulnerable Adults. Staff had signed to confirm that they have read the policy and procedure. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 standard(s) 24 and 30 Residents live in a predominantly well-maintained environment that is homely, comfortable, clean and hygienic. EVIDENCE: A good deal of work has taken place to bring the home up to the required standard; however, the following work is still required: • • • • • The paving at the front of the home is uneven and if not attended to will become a tripping hazard for Residents’, visitors, and staff. The wood frame of the external garden door is rotting and must be replaced. An extractor fan is required for the visitors’ toilet. Thought should be given to removing the Residents’ bikes from the bottom of the stairs. The up stairs fire door has flaking wood and requires attention to prevent it being compromised. The requirements that have not been met from the inspection in October 2004 are listed at the end of this report. On the day of the inspection the home was clean and hygienic.
Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32 and 35 Staff are being trained to NVQ level 2/3 which should ensure they can meet the Residents needs. Staff training takes place. EVIDENCE: 46 of the staff have their NVQ Level 2 or 3 a further two members of staff are currently studying for level 2 and a further two members of staff are to start their NVQ training this month. The following training has taken place since the last inspection in October 2004: • • • • • • Infection Control. Deliberate Self-harm. Essence of Care. Recruitment and Selection. Mandatory Training – manual handling and fire. Mental Health Promotion. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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 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 and 42. Residents’ benefit from a well run home. The quality assurance and monitoring system for the home was available for inspection. The health, safety and welfare of the Residents are promoted by the homes policies and procedures. EVIDENCE: The Manager has the required experience and qualifications to ensure that the needs of the Residents’ are met. The Residents’, visitors’ and staff spoke well of the manager stating that the home was well run and they felt that she was always available to them. There is a quality assurance and quality monitoring system in place within the home. Regular meetings are held where Residents’ can air their views and offer their opinions and suggestions about the running of the home.
Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 17 A full range of policies and procedures relating to Health and Safety were in place. Maintenance records and certificates were up to date. Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 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
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 3 x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 3 x 3 x x x 3 Standard No 31 32 33 34 35 36 Score x 2 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Ware Street Resource Centre Score 3 3 x x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 19 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 YA 24 Regulation 23 Requirement The window in the upstairs nonsmoking lounge has flaking paint and must be re-decorated. THIS REQUIREMENT IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The wallpaper and border in the upstairs non-smoking lounge is coming away from the wall in places. This must be adequately re-attached or the room redecorated. THIS REQUIREMENT IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The ceiling in kitchen 3 is patchy and detracts from the homely appearance. This must be redecorated. THIS REQUIREMENT IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The roof in the conservatory has moved causing leaks during adverse weather. This must be remedied and repaired. THIS REQUIREMENT IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The window sills in the conservatory have flaking paint and must be re-decorated. THIS REQUIREMENT IS OUTSTANDING Timescale for action 31ST December 2005 2. YA 24 23 31ST December 2005 3. YA 24 23 31st December 2005 4. YA 24 13 & 23 31st December 2005 5. YA 24 23 31st December 2005
Page 20 Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 6. YA 24 23 7. 8. YA 24 YA 24 23 23 9. YA 24 23 10. YA 24 16 FROM THE OCTOBER 2004 INSPECTION. The two external fire exit doors have flaking paint and detract from the appearance of the property. These must be redecorated. THIS REQUIREMENT IS OUTSTANDING FROM THE OCTOBER 2004 INSPECTION. The wood frame of the external garden door is rotting and must be replaced. The paving at the front of the home is uneven and if not attended to will become a tripping hazard for Residents’, visitors, and staff. The up stairs fire door has flaking wood and requires attention to prevent it being compromised. Due to the visitors toilet having no window to open an extractor fan is required. 31st December 2005 31st December 2005 31st December 2005 31st December 2005 31st December 2005 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 YA 32 Good Practice Recommendations The Registered Manager must ensure that 50 of the care staff have an NVQ Level 2 by 2005 Ware Street Resource Centre B51-B01 S38043 Ware Street V247262 010905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Unit B, Advance St Marks Court Teesdale, Stockton-on-Tees TS17 6QX National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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