Inspection on 19/05/05 for Willes Road

This inspection was carried out on 19th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Willes Road 18/07/08

Willes Road 19/11/07

Willes Road 04/07/07

Willes Road 11/07/06

Willes Road 29/11/05

Willes Road 26/10/04

Willes Road 14/05/04

Willes Road 03/02/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 26 Willes Road 26 Willes Road Leamington Spa Warwickshire CV31 1BN Lead Inspector Martin Brown Unannounced 19 May 2005 10:00 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. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 26 Willes Road Address 26 Willes Road Leamington Spa Warwickshire CV31 1BN 01926 336437 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) Turning Point Post vacant. Acting manager, Sam Wilkes PC 6 Category(ies) of LD 6 registration, with number of places 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 26/10/04 Brief Description of the Service: This house is home to five young people who have significant learning difficulties and complex behaviours. All are able bodied. The service offers 24hour staffing and high levels of intensive support and personal care. 26 Willes Road is a Georgian detached house that has been divided into two separate, self-contained dwellings. The top two floors provide three bedrooms (one with en-suite), two lounges, one dining room, kitchen, laundry, one bathroom and separate toilet and staff office for three people with severe learning difficulties. The basement provides accommodation for two young men. There is a rear entrance, two bedrooms, one bathroom, a small lounge and a small kitchen. There is a storage space that has been converted into an office come laundry. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, lasting from 10am to 5pm. During this time, service users were frequently in and out of the home with staff. All were, in their own ways, friendly, helpful, and accommodating. What the service does well: What has improved since the last inspection? What they could do better: Ultimately, the problems posed by the physical shortcomings of the home, and the problems of five people with such challenging needs living together, can only be resolved by the home’s closure, and people there moving to smaller homes where their quality of life can improve. This is to happen by March 2006. In the meantime, home must ensure that the people living at 26 Willes Road are living in a safe, comfortable, and well-maintained environment. Not only must existing maintenance issues be dealt with, but the home must be 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 6 more pro-active in identifying and dealing with future maintenance and environmental issues. 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. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 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 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 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) These standards were not fully looked at, as there are to be no further admissions to the home. EVIDENCE: Each resident at Willes Road has a copy of The Statement of Purpose and Service User’s Guide in their room. These are in clear, straight forward language and illustrated with relevant photographs. The manager is aware that some of the details, most notably references to the National Care Standards Commission, are out-of–date. As there are to be no new admissions to the home, it is agreed that other, more pressing concerns in the home may take priority over making these minor changes. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 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 standard(s) 6,7,910 Service users are supported to make day-to-day decisions about their lives. Major work is underway to support them in making choices about their future lives. EVIDENCE: Individual care plans are kept in service users’ rooms, reflecting the fact that they are their plans. One service users’ plans are locked in a chest in his room, and only got out with supervision, as they would be very likely to be damaged otherwise. The plans include pictures, risk assessments, communication guides, and guides to individual likes and dislikes, as well as life histories and issues of medical and behavioural concern. Observation of staff managing particular behaviours showed that guidelines were being observed and followed. Observation throughout the day also showed service users being consulted on their day-to-day activities, with a balance being struck between encouraging service users to take part in activities, and accepting when they were reluctant to do so. The manager and service manager advised that Person Centred Plans facilitated outside bodies are being involved in helping service users and others involved in their welfare make informed choices about their lives post-Willes 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 10 Road. This information is to be made available to Commission for Social Care Inspection. One service user had recently had initial contact with an advocate. Risk assessments were seen to be in place. Service users were seen to have freer access to the kitchen than had previously been noted. The home was taking care to ensure that information related to service users was kept to individual files, and that information in the communication book was kept as anonymous as possible. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 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) 11,12,13,14,15,16 and 17 Services users are supported by the home to take part in activities that support their personal development. Service users were either active or relaxing, and never appeared bored or aimless. EVIDENCE: All service users were out at various points during the day. Two service users went out, with staff support, on their weekly paper round. Other service users went out for walks, to coffee shops, and out shopping. A bingo session was scheduled for later in the day. Photographs and care plans showed that service users are supported to maintain close links with families Guidelines and risk assessments were available in respect of service users going out, and sufficient staff were on duty to ensure that service users activities were not restricted through lack of support. Service users are encouraged to pursue a healthy and varied diet. Staff were knowledgeable about individual preferences, and menus showed a good 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 12 variety. Fresh fruit was readily available. One service user returned from college with a meal he had prepared, with support. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 13 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 Given the constraints of a group of people, all with high and complex needs, all living together in a largely unsuitable environment, the home is working well to meet personal support needs. More permanent staff and less reliance on agency staff will lead to more consistency with this. EVIDENCE: Personal support in the home is geared very much to helping service users manage particular behaviours. Clear guidelines were seen, and observation showed them being adhered to. During the inspection, one service user had a nose bleed, which was dealt with effectively and followed up appropriately. Particular behaviours were dealt with calmly. It was recognised by staff and management that for some, if not all, the only long term and effective measure to reduce or eliminate a lot of the negative behaviours will involve relocation to smaller, more individual environments. It was clear that the more experienced, longer term staff had, understandably, a greater knowledge and awareness of the support needs of the people living at 26 Willes Road. Medication procedures were explained by the shift leader. Only those trained to do so administer medication. The medication guidelines were clear, including photographs of service users and the reasons for, and effects of medication. Recording showed administration to be accurate. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 14 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 The home has a number of mechanisms in place to help ensure that vulnerable service users are protected, and that their views are heard and heeded. EVIDENCE: The Turning Point policy on complaints was seen. Much work has been done on making the complaints process more accessible to service users, but it is recognised that the needs of the service users is such that they require a substantial level of support, from either relatives, staff or advocates, in order to pursue complaints. An advocate was introduced to a service user two days prior to the inspection. The complaints log contained a complaint by a member of staff on behalf of service users which had led to action on their behalf. Service user’s cash is checked by staff during each shift, independent auditors check the finances weekly. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 15 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 The staff and management were obviously putting effort into keeping the home clean and hygienic, it was free from offensive odours, and key areas such as the kitchens were clean. Nevertheless, the needs of the service users, and the poor maintenance of the building over the years, make it difficult for large parts of the home to seem other than in need of a thorough renovation. There are many shortcomings in the fabric and maintenance of the building, which are dealt with in the requirements section of this report, and which must be addressed, so as not to compromise the service users’ quality of life, and their health and safety. EVIDENCE: The home is a large Georgian house, which is now paying the cost of poor maintenance and unsympathetic decoration. Paintwork throughout is marked and scratched. The carpet in the front lounge is ripped in one area, and needs replacing. The view from the front window is of bins, including a clinical waste bin. The large back room has no specific use at present, having a mixture of items relating to the running of the home, and some washing drying on a clothes 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 16 horse. The manager advised that this room is being considered for use as a sensory room. The ceiling in the laundry room is in danger of collapsing. The home responded promptly to my noticing this, and the estates manager came round during the inspection to inspect the damage and its immediate impact, take appropriate steps and arrange for contractors to visit and take the necessary action the following day. There are items, such as chairs, drawers, a bed, and a cooker waiting to be disposed of, in the garden, and out the front of the house. These are, obviously, unsightly, and are potential obstructions, and must be cleared. The wooden stairs at the rear of the building are not fully secure and in need of replacement. The estates manager is aware of this, and has secured agreement for these to be replaced. These stairs are in place to be used as an emergency escape route in the event of fire. The manager has discussed this matter with the Fire Officer, and has revised fire evacuation procedures to use the front of the building. This can be done, safely, in the day, with the current one-to-one staffing ratios. Good work has been done on personalising bedrooms, but this is in the face of rooms that mostly need redecorating and refurbishing. Plasterwork needs attention in the basement lounge. The bedrooms in the basements are decorated, floored and furnished to an acceptable level. However, the faint but still persistent odour of damp arising from previous flooding demonstrates that this basement is unsustainable for suitable long term occupancy by vulnerable adults. The basement bathroom requires new flooring; the manager advised that this is in hand. The upstairs bathroom requires retiling. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 17 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) 33,35 There are sufficient staff available to allow service users to undertake activities that they were happy with and which were beneficial to them. EVIDENCE: There were enough staff on duty to ensure one-to-one work with all residents in the home. Examination of the rotas indicated that this was always the case. Staff spoken to generally had a positive view of the home and the progress being made. Samples of staff files looked at showed that core training was undertaken. A rolling programme training staff in the management of challenging behaviour was underway, with staff either having taken part in this or scheduled to do so in the near future. Where agency staff had not undertaken training such as administration of medication, they were quite aware that this was something they were not to do. The acting manager has undertaken training in supervision, and regularly supervises staff. Agency staff used by the home have their details on a proforma that includes details of a satisfactory Criminal Records Bureau check signed and dated by the agency manager as proof that it has been seen. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 18 Sample files examined showed that core training and relevant training had been undertaken. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 19 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) 39, 42 The home continues to support and encourage service users’ views to be heard and heeded. The home also continues to promote service users’ health and safety, although this is compromised by a number of issues as noted below and previously, that must be addressed. EVIDENCE: The fire procedure was seen in action when there was a false alarm, caused by the toaster. All observed doors closed properly, except for the kitchen door, which did not have a required closure device. Risk assessments were available, covering activities and risks in the home. There are regular meetings at which service users are supported to raise issues, Person Centred Plans have been commenced for individual service users, and an advocate has paid an initial visit to a service user with particularly complex needs. The kitchen is accessible to service users; it was open throughout the inspection, one service user made himself a cup of tea, safely, if messily. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 20 Safety checks, including gas, fire equipment, water temperatures, were up-todate. Fridge and freezer temperatures were recorded; many of these were outside the required range, but this does not seem to have triggered any action by staff or management. Fridge and freezer temperatures appeared within an acceptable range on the day of the inspection. There is an induction folder giving basic details about the home. Several of the contact numbers in the book were out of date, and need updating. The acting manager is to apply to register as the manager. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 21 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 x x 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 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 2 2 2 2 x x Standard No 11 12 13 14 15 16 17 3 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 26 Willes Road Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 3 x x 2 x E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 22 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 28 Regulation 23 Requirement The front lounge requires renovation, with particular attention paid to the carpet and the ceiling. The front of the house needs to be made less unsightly as veiwed from the lounge, by removing excess rubbish and shielding rubbish bins. The basement bathroom flooring requires replacing. Radiator covers throughout the home need to be properly in place. Plasterwork in the basement lounge must be made good. Unwanted items must be removed from the rear garden. The flooring in the upstairs rear bedroom must be made good. (this is outstanding from the previous inspection) The laundry ceiling must be made good. The induction folder for staff must be up-to-date. The kitchen door must have a working fire closure. The rear outside stairway must be made good. (This was subject to a requirement on 10/5/05). E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Timescale for action 30/8/05 2. 24 23 30/8/05 3. 4. 5. 6. 7. 27 42 24 24 26 23 23 23 23 16 30/6/05 30/6/05 30/7/05 30/6/05 30/6/05 8. 9. 10. 11. 24 33 24,42 24,42 23 18 23 23 30/5/05 30/6/05 30/5/05 30/6/05 26 Willes Road Version 1.30 Page 23 12. 13. 14. 24,42 42 37 23 13 8 The garden bench requires repairing. Fridge/freezer temperatures outside acceptable ranges must be acted on. The home must appoint a registered manager. 30/5/05 30/5/05 30/6/05 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 11 28 Good Practice Recommendations It is recommended that work continues on developing more detailed communication dictionaries. Better use should be made of the rear lounge area. 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Imperial Court Holly Walk Leamington Spa CV32 4YB 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 26 Willes Road E53 S58002 Willes Road V228604 UI 190505 stage 4.doc Version 1.30 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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