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Inspection on 14/09/05 for Wickett Hern Road

Also see our care home review for Wickett Hern Road for more information

This inspection was carried out on 14th September 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a stable staff group who have worked at the home for a good length of time. The staff has a clear understanding of their roles and responsibilities and have the required skills to assist guests who spend time at the home. The atmosphere within the home was lively with guests and staff interacted well. Guests spoke positively about their experience of staying at the home and enjoyed the social activities and meeting other guests.

What has improved since the last inspection?

The manager at the home has now been registered with the Commission and is working towards achieving the required management qualification. Care plans and risk assessments have greatly improved and the details assist staff to deliver accurate care to the guests who stay at the home. To improve the experiences of guests the staff have introduced a quality questionnaire that is sent home with the guests after their stay. The information should be collated and used to further develop the service.

What the care home could do better:

The registered manager must ensure that a member of senior staff undertakes a home assessment prior to guests staying at the home, to ensure guests needs can be met at the home. The age category for guests staying at the home is clearly stated on the registration certificate and an application must be submitted to enable the admission of guests who are over 65. The home has clear policies and procedure on how to store and administer medication, although the staff must ensure that medication is only accepted that has clear dispensing instructions, to prevent administration errors. Some staff training remains outstanding from previous inspections and this must be addressed by the organisation. Staff records and discussions with staff demonstrated that they have not received any training in managing challenging behaviour, this must be organised by the registered manager to ensure that staff have the necessary intervention skills. Methods of communicating with guests could be improved, as most staff do not have skills in the use of sign language including Makaton.

CARE HOME ADULTS 18-65 Wickett Hern Road 123 Wickett Hern Road Armthorpe Doncaster DN3 3TB Lead Inspector Val Hoyle Unannounced 14 September 2005 13:00 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. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Wickett Hern Road Address 123 Wickett Hern Road Armthorpe Doncaster DN3 3TB 01302 831969 01302 833616 None Doncaster Metropolitan Borough Council 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) Edmund James Watkins Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The emergency bed is used for a maximum of 12 weeks Date of last inspection 03 March 2005 Brief Description of the Service: Wickett Hern Road provides a respite service for adults with a learning disability. The home is owned and managed by Doncaster Metropolitan Borough Council. The home can accommodate eight service users; one of the beds is made available for emergency admissions for short stay only. The facility is set within the residential area of Armthorpe on the outskirts of Doncaster. Previously a family home the premises provide a domestic environment for temporary stays.The home has its own transport and this assists service users to maintain their education, work or day centre placements during a period of respite. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection was conducted over 4.5 hours where a partial tour of the building was undertaken. The inspector examined three guests (service users) care plans and supporting documentation. Five guests (service users) and four staff were spoken to during the visit. The deputy manager assisted with the process while examining records, policies and procedures. What the service does well: What has improved since the last inspection? The manager at the home has now been registered with the Commission and is working towards achieving the required management qualification. Care plans and risk assessments have greatly improved and the details assist staff to deliver accurate care to the guests who stay at the home. To improve the experiences of guests the staff have introduced a quality questionnaire that is sent home with the guests after their stay. The information should be collated and used to further develop the service. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 6 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. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 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 Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 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) 1, 2, 5, Guests (service users) are not admitted into the home without a full needs assessment taking place by the registered manager, to ensure their needs can be met. Procedures ensure that visits take place prior to any arranged stays at the home. The Statement of Purpose provides information about their stay at the home, and a contract of residence between the home and the guest has been developed. EVIDENCE: Information about the services provided at the home is being developed in ‘easy word’ that will enable guest to understand what they can expect when they spend time at the home. Contacts between the home and the guest are now used and evidence was seen on the guests care plans to confirm this. There is a comprehensive assessment used to assess the needs of prospective guests who spend time at the home. The placing authority also provides detailed information about the person and this was examined and the deputy manager said it is used in all cases, including emergency stays, to ensure staff are able to meet the needs of guests. New guests are always encouraged to Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 9 visit the home for tea and meet other guests and staff before making decisions about if they want to use the respite services. At present the staff at the home do not visit guests in their own home environment. This is an essential part of the pre-admission process and must be introduced. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.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, 9. The care planning system has greatly improved to enable staff to deliver the care to service users who have specific identified risks. Guests or their relatives are given the opportunity to agree and sign their care plan, so that they are fully aware of the care they can expect to receive. Guests are supported and encouraged to make decisions about their lifestyles ensuring continuity from time spent at Wickett Hern Road and their own homes. EVIDENCE: The three care plans examined reflected the care and assistance required. They described in detail what staff have to do to maintain the health and safety of guests including risks that may occur outside of the home. Guest’s care is reassessed after each stay and staff at the home are invited to attend formal reviews held at the training centres where the guests attend during the day. Parents and family are also invited to attend the meetings to discuss future stays at the home. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 11 One care plan examined showed clear evidence that the guest had the opportunity to be involved fully in developing her/his own care plans and the intervention she/he needed. As this is a respite service there is emphasis on supporting the same level of independence in decision making that the guest have at home. For many of the guests the respite stay is also an opportunity to make decisions without family support. Staff recognise the need for consistency and ensure that care records detail issues that the service user may have difficulty making decisions about. Guests returned from day services and immediately were involved in making decisions about meals and activities, Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 12 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) 12, 13, 15, 16. Social and leisure activities are provided at the home for guests to maintain and develop independent living skills, supported by an informed staff group. Guests are helped to maintain links with family members and follow routines outside of the home, although relatives usually take the opportunity to take a holiday break, while guests are in Wickett Hern road. EVIDENCE: Transport to help guests pursue leisure activities outside of the home during their respite stay. Guests said that they have the opportunity to go out as a group especially at the weekends. Staff confirmed arrangements to integrate guests into the community and said it was an important to offer this service, so that they are able to develop social skills. The provision of respite care at the home means that guests return to their families after their stay, and therefore staff are aware of the importance of maintaining routines to ensure continuity of care for when they return to their own home environment. Guests said they looked forward to their stays but realised that they would return home, and all guests spoken to were fully aware of when they would be returning home. Two guests who are friends Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 13 outside of the home arrange their stay so that they are at the home at the same time. They said they enjoyed their stay and talked about common interests including sporting achievements and watching their favourite TV programmes together. Guests are encouraged to help with tasks around the home such as laying the tables for meals and helping clear away the pots and help with the dishes. There were many good examples of staff interacting with guests and all guests were referred to by their first name. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 14 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. Staff provides sensitive personal support to ensure privacy dignity and independence is maintained for all guests. Medication policies and procedures do not always ensure the safety and protection of guests at the home. EVIDENCE: Guest retains their own GP whilst staying at the home, although an emergency arrangement can be made if needed. Records examined and discussion with the deputy manager confirmed guest’s healthcare needs are met. Guest are escorted to medical appointments by staff and comprehensive records are completed ensuring information is shared with those who care for the individual. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 15 Guests and their carers are responsible for ensuring that sufficient medication is sent to the home while receiving respite. The senior on duty is responsible for checking and logging all medication. A metal cupboard is used to store the medication and this is in a lockable cupboard. An audit of stock levels and examine records, demonstrated accurate recording. The registered manager must only accept medication in its original boxes/bottles and labelled correctly by the dispensing chemist, to ensure the safety and protection of guests. Any guest wishing to self medicate can do so, this is risk assessed and there is provision of a lockable facility in each bedroom. The staff have all successfully completed an accredited distant learning course on the administration of medication. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 16 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. Guests are provided information to enable them to raise concerns about the home and their care. Adult Abuse Policies and procedures and training of staff on abuse, ensures the protection of guests from abuse. EVIDENCE: The home has a complaints procedure that is available to guests and visitors. The procedure is also referred to in the information given to new guests, identifying the stages to follow; this includes the time scales to respond to complaints. The address and telephone number of the Commission for Social Care Inspection is included in the procedure. One guest said she/he would “tell one of the staff if she/he was upset about something”. The registered manager has a copy of the Local Authorities Adult Protection procedures. They also have an Abuse Policy, which has been prepared by the owners and is incorporated into the homes policy and procedure manual. The manager reiterates the procedures at staff meetings and supervision and staff training files also confirms types of abuse and how to respond to any incidents. The manager ensures that all the necessary checks are carried out on new staff for the protection of vulnerable adults. The manager is aware of the POVA guidance and this was discussed with the Inspector. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 17 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, 30. The home provides a well-maintained safe environment suitable for guests to spend their time. The home provides a clean and hygienic environment to maintain the health and safety of guests. EVIDENCE: A partial tour of the building found it clean and free from odours. The home provides comfortable communal areas with one lounge and a dining area. There is a separate domestic kitchen. The grounds were tidy, and accessible to the guests, the rear garden includes a small lawned area. It is well situated in Armthorpe, within easy walking distance of all local shops, and parks. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 18 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, 33, 34, 35. Sufficient staff are employed at the home to meet the needs of guests. Staff have the skills to fulfil their roles within the home, although their remains some outstanding training that needs to be addressed. A stable staff group ensures continuity of care by staff that knows the guests. Recruitment policies are followed ensuring the safety and protection of guests. EVIDENCE: Staff rotas examined showed adequate levels to meet the needs of the guests. Staff have adequate skills to meet the needs of guests, although they do not meet the requirement of 50 NVQ qualified staff. A number of staff are working towards the award. Staff recruitment files are held centrally at DMBC, and they have responsibility for ensuring references and CRB checks are obtained prior to commencement of employment. Staff training files examined showed evidence of a comprehensive induction programme and training records showed that staff still require training in infection control, adult protection, and health and safety. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 19 Discussion with the deputy manager indicated that staff have not received any formal training to deal with challenging behaviour, therefore staff must attend a behaviour management course to ensure they have the necessary skills to deal appropriately with guests. Discussion with staff identified that they are not always able to communicate with guests and require training in the use of Makaton signing. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 20 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, 39, 42. The home is well managed to ensure the safety and protection of the guests. Staff and guests follow health and safety procedures and records provide evidence of servicing of essential equipment. The manager has a positive approach to gaining the views of guests and their relatives, by developing methods to gain their views. EVIDENCE: The registered manager was unavailable during this inspection and the deputy manager assisted with the examination of documents. The Commission recently registered the manager, although he has been in post for over a year. He is currently undertaking the registered managers award and is aware of the requirement to achieve the award by the end of 2005. A quality assurance survey is undertaken by the home when guests return home after their stay. The survey is used to gather the views of guests and Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 21 their families. Examination of the surveys and discussion with the deputy manager demonstrates an understanding of quality assurance methods, although there was no clear evidence of how the results of the surveys are collated, or where improvements to the service is required. Maintenance and service records examined were up to date and current to the services provided. Accident records were fully completed for both guests and staff and the manager carries out her own investigation. The manager has the required Health and Safety policies and procedures and displays the relevant notices. Fire safety procedures are in place and service records were examined and were current. Staff have now received fire instruction as required on the previous inspection report. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 22 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 2 x x 3 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 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 x Standard No 31 32 33 34 35 36 Score x 2 3 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Wickett Hern Road Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 3 x 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 23 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 YA2 Regulation 14 Requirement The registered manager must not admit guests (service users) over the age of 65 The registered manager must ensure that all per-admission procedures are completed including visits to the guest (service user) in their own home The registered manager must ensure medication is only accepted in its original container with chemist printed labels The registered provider must ensure the staff have the necessary knowledge and skills in behaviour management. The registered manager must ensure staff receives all statutory training. The registered provider must ensure that staff have the skills to communicate using Makaton. Timescale for action 31.08.05 2. 2 14 1 December 2005 3. 20 13 31.08.05 4. 35 18 1 December 2005 Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 24 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 32 37 Good Practice Recommendations 50 of care staff achieve a care NVQ 2 by 2005 The manager should achieve NVQ4 in management and care in 2005. Wickett Hern Road 20050831 Wickett Hern Road X00023 U Stage 4 S32121 V194137.doc Version 1.40 Page 25 Commission for Social Care Inspection 1st Floor, Barclay Court Heavens Walk Doncaster DN4 5HZ 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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