Care Home: 156 Eccleshall Road

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What the care home does well The two people who use the service are totally accepted into the family of the provider. Their care and support is provided by Mrs Wilson, supported by her husband and their daughter who acts as carer when necessary. The service is located on a busy main road near to the town and on the local public transport route. The environment is comfortable and very homely. Each of the rooms have been tastefully furnished and decorated. The atmosphere is warm and friendly.The manager continues to keep a good standard of documentation for people who use the service. Where possible, people who use the service are involved in the planning of their care. People who use the service are comfortable in their environment and happy with the care provided and daily routines. . What has improved since the last inspection? The previous inspection report made no requirements for improvement. What the care home could do better: Minor issues were discussed with the provider Mrs Wilson. It was suggested that she reinstated the separate locked cupboard for the use when and if necessary to contain any controlled medication. To add the strength of the one medication taken by one of the people who use the service. To make an addition to the record of the time taken during a fire drill. When necessary the provider has agreed to send any incident or accident reports to us for our attention. CARE HOME ADULTS 18-65 156 Eccleshall Road 156 Eccleshall Road Stafford Staffordshire ST16 1JA Lead Inspector Wendy Grainger Key Unannounced Inspection 26th June 2008 10:15 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 156 Eccleshall Road Address 156 Eccleshall Road Stafford Staffordshire ST16 1JA 01785 604222 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) Mrs Patricia Ann Wilson Mr Peter Wilson Mrs Patricia Ann Wilson Care Home 2 Category(ies) of Learning disability (2) registration, with number of places 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th December 2006 Brief Description of the Service: 156 Eccleshall Road provides personal care to two adults with mild learning disabilities. The service’s aim is to provide care in a ‘family setting’. The building is a large semi-detached house on the main road leading into Stafford. Although within walking distance of Stafford there is a bus route available. The building has three floors and a cellar. People who use the service have bedrooms on the first floor. The second floor provides private accommodation Mrs Wilson (the provider- manager) and her husband. The cellar is used as an office. The laundry is in an outhouse close to the kitchen. The service has large, attractive rear gardens with patio areas. The reader may wish to contact the service direct for up-to-date information about fees and charges. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The overall rating for this service is two star. This means the people who use the service experience good quality outcomes. The manager who is also the provider and one of the people who use the service were involved in our inspection. Each of the people who use the service completed one of our “have your say” survey forms. Comments made by the one person who uses the service confirmed information that was recorded in our completed “have your say” surveys. They are “happy living in the service, where they have choices on a daily basis”. Both people who use the service confirmed, “ we had visits and weekends stays before we made up our minds to come here” This key inspection was completed without a Annual Quality Assurance Assessment (AQAA ). The provider Mrs Wilson had completed an AQAA unfortunately it could not be located prior to our inspection. We looked at a number of records as part of our inspection process, which included; care plans, fire records, medication records, maintenance records and servicing records. What the service does well: The two people who use the service are totally accepted into the family of the provider. Their care and support is provided by Mrs Wilson, supported by her husband and their daughter who acts as carer when necessary. The service is located on a busy main road near to the town and on the local public transport route. The environment is comfortable and very homely. Each of the rooms have been tastefully furnished and decorated. The atmosphere is warm and friendly. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 6 The manager continues to keep a good standard of documentation for people who use the service. Where possible, people who use the service are involved in the planning of their care. People who use the service are comfortable in their environment and happy with the care provided and daily routines. . What has improved since the last inspection? What they could do better: Minor issues were discussed with the provider Mrs Wilson. It was suggested that she reinstated the separate locked cupboard for the use when and if necessary to contain any controlled medication. To add the strength of the one medication taken by one of the people who use the service. To make an addition to the record of the time taken during a fire drill. When necessary the provider has agreed to send any incident or accident reports to us for our attention. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 2,4. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. No person is admitted to the service without a full assessment of their needs being undertaken. People are encouraged to visit and ‘test-drive’ the service before they move in to help them decide if it will be suitable for their needs. EVIDENCE: The provider has developed Service Users Guide in a picture format so that people who wish to use or use the service can better understand it. Both people using this service have been living there for some time. Records we looked at showed us that a range of professional agencies had been involved in the placement of these people before they used the service. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 10 Completed surveys and conversation with people who use the service confirmed, “I came here to visit, then for weekends” “ I liked it, so I moved in.” 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 11 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service ensures that people are supported appropriately by maintaining comprehensive care plans and risk assessments and involving individual people in their care planning. EVIDENCE: One person agreed for us to view her plan of care. We found that this document to be a lengthy and comprehensive plan of care based on the person’s individual needs. It included a social plan, involvement with other agencies, medication and risk assessments. We were impressed with the content of it. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 12 We saw that people’s care plans are reviewed on a monthly basis; evidenced in the plan were dates planned for review in July 2008. This is good as this means that everyone is aware of any new needs and people have the chance to change their plans regularly if they should wish to. The provider is fully aware of the daily routines of the people who use the service. She supports their choice to be as independent as possible, while recognising each of the two people have different needs and capabilities. One person present during our inspection told us that she ‘could do what she wanted to do’, this was confirmed in completed “have your say” surveys. Both people who use the service confirmed ‘“ We can discuss any issues with the manager”, we “always” make decisions about what we do in the day and weekend,” “we always have support 24/7.” 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 12,13,14,15,16,17. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Each person who uses this service has a life style that has been specially developed to make sure that it meets their expectations and needs. EVIDENCE: One of the people who use the service has been encouraged to develop her skills and is now in paid employment with a local Social Services Department on a part time basis. Encouraged by the provider this person has attended a training course for selfadvocacy. A full and active social life is experienced by the people who use this service one person has a personal relationship. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 14 Care planning for people is updated when necessary for example; as they advance in age. From the records we looked at, our observations and talking to people we found that all care was age appropriate. We were impressed with the documentation written in picture form for the people who use the service to help them understand it more easily. One person who uses the service told us that the food is “good”. She likes the different meals served. A healthy eating diet was part of this person’s chosen menu. Menus are based on fresh produce from the garden, cultivated by the providers. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19,20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are supported to ensure their physical and emotional needs are met. EVIDENCE: People who use this service receive personal support to make sure that their needs and capabilities are considered. The care provided reflects what is recorded in individual’s plan of care. Arrangements are in place for the continued health care from other professional agencies. The provider told us that when necessary people who use the service attend appointments at the hospital, chiropody, dentist and optician. The manager when needed provides transport to these appointments. The provider has acted on the advice provided for one of the service user and a behavioural difficulty. Records seen evidenced the external support provided. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 16 People who use the service are encouraged to maintain independence. Both attend the local day service, college, and voluntary work placements. People have a full social life of their choice internal or external to the home away out of the County. We found that medication is secured appropriately. Medication records we looked at were satisfactory and current. The service has written medication policies and procedures so that staff have guidance on how to maintain medication safety. To increase medication safety further we have made a recommendation that hand written medication records detail the strength of medications prescribed. One person is provided with a monitored dose system and record. We saw that a locked cupboard is not available for storing controlled medication. We discussed this with the provider who agreed to re-instate the locked cupboard in case controlled medication is prescribed in the future. One person we spoke to told us, “ I take my tablets not by myself” indicating that people are encouraged to be independent but processes to prevent risk are in place. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22,23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Processes are in place to make sure that people’s views are heard and acted upon. People who use the service are protected from abuse. EVIDENCE: We were impressed with the pictorial complaints processes provided to the people who use the service. One person told us that she was ‘aware how to make a complaint’. She told us, “ I know how to complain it’s in my file” “ I can speak to the staff or an advocate” Staff training provides the necessary awareness to protect the people who use the service. There have been no issues raised with us or with the safeguarding team since the previous inspection in 2006. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,30. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People who use the service live in a comfortable, safe, hygienic and homely environment. EVIDENCE: Located on a busy road into the town of Stafford, the service is ideally positioned in the community. We saw that the environment was homely, exceptional clean and well furnished. The sun lounge at the rear of the home provides extra space, this leads to an exceptionally well thought out garden. Animals, geese and chickens live in the garden. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 19 One person invited us into her bedroom. We saw that this bedroom was personalised with possessions and family photographs. The person told us about their family members and the origin of their porcelain doll collection. Bathing and toilet facilities are situated on the same floor as the bedrooms of people who use the service. An additional separate toilet is provided on the ground floor. Records we looked at confirmed that electrical equipment and other white goods are under contract. All have a 24hr call out agreement if there is a fault. Records we looked at for fire prevention and evacuation procedures in the event of a fire were current. The only comment we made to the provider was that she considers putting a time in the records of how long fire drills take. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32,34,35. Quality in this outcome area is good, This judgement has been made using available evidence including a visit to this service. A committed and experienced staff team support the people who use the service. EVIDENCE: The main carer for the people who use this service is the provider who is also the manager. The provider’s daughter is available to support the manager when needed. The manager’s husband is responsible for maintenance of the premises and garden. People who use the service are supported on a daily basis, transported if necessary to particular events and appointments. The provider impressed us with her commitment to the people who use the service and her recognition of their needs. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 21 Staff training is on going when necessary. The manager’s daughter is planning to update her First Aid training. The manager is registered with the Skills Work Force that keeps her in touch with courses and training events. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 22 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37,39,42. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. People benefit from a well-organised service, which is operated by experienced and dedicated people. EVIDENCE: The service operates in the best needs of the people who use it. People are encouraged to be as independent as possible, having the opportunity to experience the community and enjoy a good social life. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 23 The provider who is also the manager has over twenty-five years experience in caring. She has achieved the National Vocational Qualification levels 2 and 3. Her background is teaching sign language “Makaton”, plus communication of the sensory impaired. Her training is updated during her role as carer with the organisation Mencap. She works on a weekly basis with this organisation. At the time of our inspection the manager’s training was current in the areas of:First Aid. Health & Safety Fire training. Food Hygiene. Infection control. The manager’s husband has also attained a Food & Hygiene certificate. People who use the service told us in completed “Have your say” survey’s that the “staff listen and act on what we say” “ I can speak to staff at any time and they will always help me” We looked at financial arrangements for the people who use the service and found systems to be satisfactory. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 24 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 Standard No 1 2 3 4 5 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score x 3 X 3 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 25 N/A 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. Standard Regulation Requirement Timescale for action 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 YA20 Good Practice Recommendations To increase medication safety we strongly recommend that hand written medication records detail the strength of any medication prescribed. 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 156 Eccleshall Road DS0000005079.V366839.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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