Inspection on 28/10/05 for Wrekin Cottage

This inspection was carried out on 28th October 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Wrekin Cottage 22/10/08

Wrekin Cottage 04/07/07

Wrekin Cottage 08/09/06

Wrekin Cottage 17/05/06

Wrekin Cottage 07/06/05

Wrekin Cottage 05/01/05

Wrekin Cottage 23/06/04

Wrekin Cottage 16/02/04

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 Care Ironbridge Forbes Close Ironbridge Telford Shropshire TF7 5LE Lead Inspector Mike Moloney Unannounced Inspection 28th October 2005 10:00 Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 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 Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 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. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Care Ironbridge Address Forbes Close Ironbridge Telford Shropshire TF7 5LE 01952 432065 01952 432209 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) CARE (Cottage and Rural Enterprises Ltd) Care Home 30 Category(ies) of Learning disability (30) registration, with number of places Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th June 2005 Brief Description of the Service: Cottage And Rural Enterprises (Limited) is a registered charity established in 1966. The Company has communities nationwide and its headquarters are based in Leicester. Care Ironbridge is a residential development that occupies a small cul-de-sac in the Ironbridge area of Telford. The development was purpose built and is situated close to local amenities and is a short journey from Telford Town Centre. Severn and Wrekin Cottages are registered with the Commission for Social Care Inspection to provide accommodation and personal care to a maximum of thirty adults with learning disabilities. The cottages are set in beautifully maintained and attractive gardens. In addition to the cottages, service users have access to workshops, a community centre, communal dining room and games area, which are all provided, on the main site of this development. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place during the morning, was carried out by two inspectors who were on the site for three hours. The inspection methodology of the Commission for Social Care Inspection is proportionate and therefore as this was the second inspection for this year only those Key Standards that were not assessed at the last inspection and standards where there were outstanding requirements or where issues came up during the visit were inspected. Two buildings are included within this registration, Severn Cottage and Wrekin Cottage and given that there were no outstanding requirements in relation to Severn Cottage this visit focussed on Wrekin Cottage. During the visit inspectors were able to talk to service users, visiting parents, staff and managers. A variety of records were also seen as were various parts of the building and the grounds. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: No new service users have been admitted since the last inspection therefore it was not possible to assess Standard 2 Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 9 Potential hazards to the service users are properly risk assessed. EVIDENCE: A number of risk assessments were seen by the inspectors and these contained all of the information needed to establish safe levels of involvement by service users in a variety of activities. Discussions with a service user and her parents established that they feel that they are properly involved in the risk assessment process adopted by the home and that any restrictions that may be involved are acceptable. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 9 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 17 Service users are expected to be responsible, as far as they are able, for general household duties. They are provided with well-balanced and wholesome meals. EVIDENCE: Service users were seen to be moving freely around the home. Those service users wishing to be alone were able to use their own bedrooms which could be kept secure as they were all fitted with locks. One service user was seen helping with the cleaning and another confirmed that she is expected to help as well ensuring that they are involved in the day to day responsibility for the state of the home. They were also seen to chat freely with the staff throughout the visit. It was reported that the menu for Severn Cottage is under review. From talking to staff it was clear that the menu for the evening meal had yet to be decided but would be based on the knowledge of the likes and dislikes of the service users. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 10 Since the last inspection each cottage has been provided with a food budget; which, staff say, has provided greater freedom and choice of meals for service users. Service users will be involved with budget meetings. Lunch during weekdays is provided in the main dining room on site and service users are provided with a choice of main meal and desert. The meals available on the day of the inspection appeared to be balanced, were well presented and people requiring special dietary requirements were catered for. Good stocks of fresh fruit and vegetables were readily available in the main kitchen based on site. Service users were seen in the kitchen assisting with meal preparation and the serving of meals. Service users spoken with said that they enjoy the food. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 11 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): 20 The home has appropriate systems for the administration of medication. EVIDENCE: The home has to manage the medication for the service users. Medication records were seen to be properly completed ensuring that the correct person got the correct medication at the right time. The medication was also seen to be stored appropriately. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 12 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): 23 The home has procedures in place to safeguard service users from potential abuse. EVIDENCE: Since the last inspection there have been two referrals made to the Protection of Vulnerable Adults (PoVA) team under the local adult protection procedures. One referral was made relating to one service user following two separate incidents. There was a delay in reporting one incident that meant a delay in the process designed to ensure any victim’s safety and managers acknowledged this. Joint Planning meetings have been held and the home has taken action following recommendations made in order to safeguard the individual concerned. The home has also helped one person to make a referral within the Local Policies and Procedures for the Protection of Vulnerable Adults and be involved in the subsequent stages. Discussions with staff during this visit showed that they had an understanding of the protection of vulnerable adult procedures. The Residential Services Manager reported that senior staff have all received training in the local PoVA procedures. She also reported that the training officer visits the home and provides the rest of the team with basic training in adult protection. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 13 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): EVIDENCE: Both Standards 24 and 30 were fully assessed at the last inspection. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 14 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): 33 and 34 Staffing levels in Wrekin Cottage are not adequate to support the assessed needs of all service users and restrict opportunities for community presence and participation. The home has a safe recruitment process. EVIDENCE: It was required at the last unannounced inspection undertaken on 7th and 9th June 2005 that staffing levels in Wrekin Cottage be reviewed as there are occasions when there are only two staff on duty and some service users require constant supervision due to medical care needs. Discussions held with staff on duty confirmed that staffing levels do not fall below two staff to support the fourteen people accommodated. Discussions with those staff suggested that the dependency levels of the people living in the cottage has increased and staff are now having to assist more with attending to their personal care needs and subsequently not being able to devote as much time to enabling social activities away from the home. It is evident that staff are committed and are working additional hours and undertaking extra sleep-in duties to provide service users with consistency in care, however they are feeling tired and pressurised with the current working arrangements. Rota’s seen for the month indicates a high level of care agency workers. The staff explained that agency staff are used who are familiar with the needs of the people living at the home. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 15 Records seen showed that team meetings are held monthly and that the appropriate pre-employment checks as well as copies of documentation relating to the interview process. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 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): 39, 40 and 42 Systems are in place that protects the health, safety and welfare of the service users. EVIDENCE: Discussions with senior management of the home who were present at the time of the visit demonstrated that there is a comprehensive quality assurance process in place that is designed to ascertain the views of the service users and their families. Discussions indicated that it is expected that this process will more closely link with the person centred planning approach as it becomes more established within the home. The manager who explained this process had also been tasked with the reviewing of the organisations policies. Further discussions with him and looking at some of the documents concerned showed that this process was nearly completed. It was reported that the home has recently received a new updated version of the health and safety manual. Risk assessments for safe working practices were seen on the three care files sampled during this inspection and were comprehensive with evidence of regular review. A member of staff reported Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 17 that risk assessments are currently under review and the information will be simplified. Records seen showed that bath water temperature checks had not been done since 13.09.05. These checks carried out later that day and the information faxed to the CSCI. COSHH checks are undertaken monthly and products are appropriately stored and data sheets available. Records for service users receiving COSHH training were also seen on the care files sampled. The fire log and the accident/incident records were seen to be kept appropriately. Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 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 x x x x x Standard No 22 23 Score x 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score x x x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x LIFESTYLES Standard No Score 11 x 12 x 13 x 14 x 15 x 16 3 17 Standard No 31 32 33 34 35 36 Score x x 1 3 x x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Care Ironbridge Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x x 3 3 x 2 x DS0000020540.V262577.R01.S.doc Version 5.0 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 YA33 Regulation 18 (1) (a) 19 Requirement The home must have sufficient staff on duty at all times to meet the assessed needs of service users. A record of the findings of the bath water temperature checks must be maintained. Timescale for action 31/12/05 2. YA42 13(4) 11/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection Shrewsbury Local Office 1st Floor, Chapter House South Abbey Lawn Abbey Foregate SHREWSBURY SY2 5DE 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 Care Ironbridge DS0000020540.V262577.R01.S.doc Version 5.0 Page 21 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!