Care Home: 38 Church Street

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What the care home does well The staff know how to support and care for the established community. Staff encourage/support the residents to make choices about what they wish to do and how they spend their lives. Residents are enabled and supported to enjoy a positive lifestyle through varied activities, contact with the local community, contact with friends and family. Residents live in clean, personal and comfortable accommodation. Staff are correctly recruited and receive comprehensive training in order to support the residents living in the home. What has improved since the last inspection? Staffing levels have been increased to meet the increasing dependency of one resident. New settees have been provided for each self contained flat. New dining room furniture and a special profile bed have been purchased to improve the quality of life of the residents and make it safer for staff to assist a resident. What the care home could do better: There were no requirements from this inspection visit. It is recommended that the manager ensure that each member of staff is given a copy of the General Social Care Council`s Codes of Practice. It is acknowledged that efforts have and are to be made to make the rear garden accessible and usable by the residents. However, we note this was highlighted at the previous inspection. CARE HOME ADULTS 18-65 38 Church Street Pinchbeck Spalding Lincs PE11 3UB Lead Inspector Tobias Payne Unannounced Inspection 12th October 2007 08:30 38 Church Street DS0000032997.V342111.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 38 Church Street DS0000032997.V342111.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. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 38 Church Street Address Pinchbeck Spalding Lincs PE11 3UB 01775 711103 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) sue.woodall@sense.org.uk www.sense.org.uk Sense, The National Deaf blind and Rubella Association Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (0) registration, with number of places 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd August 2006 Brief Description of the Service: The home is one of a number of care homes operated by SENSE East. The property is owned by a housing association, which has maintenance responsibilities. It is located in a residential area of the village of Pinchbeck, which has a number of shops, pub, a church and other amenities, with the nearby town of Spalding providing a wider range of facilities. The home is registered to provide personal care for up to six residents between eighteen and sixty-five years of age who have a sensory impairment and/or a physical disability, and any associated conditions. Three residents live in single en suite rooms downstairs. There is a communal lounge and dining room. There are three self-contained flats upstairs, each with a bedroom, sitting room/kitchen and bathroom. There is a stair lift to the upper floor. The secure garden at the back is not accessible to all residents at present. There are plans outstanding to landscape it; install raised beds and ramps to enable all residents to enjoy the garden. There is a small car parking area for staff and visitors at the front of the house. The home has two minibuses, one accommodating a wheelchair, to transport residents to local activities. The fees on the 12/10/2007 ranged from £1,141 to £2,294, 98p each week. Additional fees include hairdressing, personal toiletries etc. The statement of purpose, service user’s guide and information about the home can be obtained from the manager of the home. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and used all the information we have about 38 Church Street. The inspection visit started at 8.30 am. In view of the communication needs of the residents in the home, we relied on observations between the staff and residents, information provided by the staff and records as evidence as to whether the standards were met. The main method of inspection was case tracking, which is tracking the care received by selected residents. The care plans and records of two residents were examined and general care practices observed. We spoke with 4 staff during our inspection visit. Staff were very positive about working in the home and praised the teamwork and supportive atmosphere. What the service does well: What has improved since the last inspection? What they could do better: There were no requirements from this inspection visit. It is recommended that the manager ensure that each member of staff is given a copy of the General Social Care Council’s Codes of Practice. It is acknowledged that efforts have and are to be made to make the rear garden accessible and usable by the residents. However, we note this was highlighted at the previous inspection. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 6 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. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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 Outcomes Statutory Requirements Identified During the Inspection 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 1, 2, 3 and 5 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. There is very clear information about the home available in a number of different forms to enable each resident to make an informed choice as to whether or not to come to the home. Each resident also receives a careful, sensitive assessment, which results in their needs being met. EVIDENCE: The present residents have been at the home for some time and new admissions were infrequent. There was a statement of purpose and service user’s guide, which was up to date. These could be produced at request in large print, CD Rom, pictorial symbols and languages other than English. If a new person was admitted to the home the Sense Assessment Co-ordinator would carry out a thorough assessment of their needs. The manager would also assess the resident’s needs. No resident would be accepted as an unplanned or emergency admission. Relatives would be informed in writing that the home could meet all the assessed needs. The home encouraged prospective residents and their family and friends to visit the home and meet the other residents before deciding to move there. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 9 An individual contract was drawn up between Sense and the sponsoring authority. Copies were made available to residents or their supporters on request. Each resident was given a copy of the home’s statement of purpose and terms and conditions within the home. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6, 7 and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents’ needs are met by comprehensive person centred care planning and staff know and understand how to meet the needs of the residents. Residents are supported and helped to make decisions about their lives. EVIDENCE: Each resident had a detailed and person centred care plan. This was produced wherever possible with the involvement of the resident, their family/advocate and other relevant people. The acting manager was in the process of reviewing all care plans. Records were very detailed and included personal details, care plan, health plan, communication profile, behaviour guidelines, risk assessments, review reports, contract and funding arrangements and family details. Records were very clear, up to date with dates of review. There were also specific information about nutrition, interests, moving and handling, daily routine, skills and abilities and evening activities. There was a statement of support with action plans covering all aspects of daily living and specific needs. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 11 Some residents had limited communication skills and alternative communication methods were included in the plans. Staff had been trained to use British Sign Language (BSL) and had worked to compile lists of words that residents were able to use. Families were fully involved in plans and attended the review meetings. The home did not hold residents’ meetings but residents were able to communicate their wishes and preferences on a day-to-day basis. During the inspection visit we saw staff explaining in a kind, calm sensitive manner what they were doing. Staff showed knowledge about the individual needs of the residents and went about their work in a professional manner. There were good working relationships with families as on the day of the inspection visit 2 members of staff were about to take one resident home for a family birthday. This had been planned with the involvement of the resident, family and staff. This was taking place in an unhurried and considered manner with the emphasis on ensuring that everything being done was to suit the resident. Residents took part in activities outside the home and were encouraged to live as independently as possible, including cooking their own meals. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 11, 12, 13, 14, 15 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents are involved in meaningful, appropriate activities, which include educational, work, and recreational activities. Staff have the knowledge to support them in these activities. Meals provided are nutritious and varied. EVIDENCE: When any new resident was admitted to the home information was obtained about their food preferences, likes and dislikes and their lifestyle. Residents were encouraged to develop new skills and improve existing ones. Examples included basic literacy, assertiveness or social skills. Goals were agreed in care plans and progress was recorded. Four residents went to the Glenside Resource Centre operated by Sense Monday to Fridays between 09.30 and 16.15 hours. They were taken there by staff in a mini-bus and took part in age, peer appropriate activities. One resident worked at a local supermarket accompanied by a member of staff and 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 13 efforts had been made to establish a very good relationship between the home the supermarket and the resident. Another because of their needs spent time at home but went out with staff. Residents were encouraged to maintain their interests in activities they had previously enjoyed. There were a range of leisure activities outside of the home. These included bowling, swimming, contact with animals, hydrotherapy, visits to the theatre, entertaining friends and karaoke. Residents also spent time with their family. Staff accompanied some residents; others were able to make the journey alone. Relatives and friends were welcome at the home and they were encouraged to be fully involved in daily routines, with the resident’s permission. Residents could choose to have visitors in their room or in private. Staff had received training on sexual awareness, covering relationships and other issues likely to be met by young residents. During our visit we saw staff caring and supporting the residents in a calm, relaxed and friendly professional manner. Some residents were able to shop and cook their own meals. They were encouraged to discuss their choices to ensure they had a balanced diet. The home had a four-week menu, compiled by residents, reflecting their likes, dietary needs and any food intolerances. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents’ health and emotional needs were met. Medication was safely and correctly given by staff who knew what they were doing. EVIDENCE: Residents could be referred to GPs, Community Nurses, Dentists and Opticians. Where required, other services could also be obtained. The health of residents was continually monitored to identify potential complications. Weight, dietary and fluid intake was recorded where necessary. Sense had a very detailed and clearly written medication policy. All staff responsible for giving medication had been trained and assessed as competent to give medication. We had been informed of a medication error, which had not affected the residents. Sense had acted promptly and reviewed procedures. We saw a medication round taking place. Care was taken and we saw medication being given correctly. We had no concerns about the action by Sense and had been kept fully informed. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Considerable efforts have been made to ensure that any complaints received are treated properly and residents and visitors know that any complaints would be addressed and taken seriously. Staff are recruited correctly to ensure that residents are protected from abuse. EVIDENCE: Sense had a detailed complaints procedure “Resolving Issues”, which gave written and pictorial guidance about how a resident can raise any issues. This could be provided in Braille, tape or other languages other than English. No complaints have been received by the home or us since the last key inspection. The home had an adult protection policy and a copy of Lincolnshire’s Adult Protection policy. All staff as part of their induction received abuse training. They also receive yearly refresher training programme in the form of a questionnaire to test their knowledge. We spoke to a member of staff who knew what abuse was and what they should do if abuse was suspected. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 16 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, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a comfortable, safe, clean, well decorated home. EVIDENCE: The home was in a residential area and indistinguishable from those around it. Ramps gave access to all, including wheelchair users. It was clean, comfortable, safe and odour free throughout. Since the last inspection decoration and refurbishment had taken place Residents were encouraged to make their rooms personal with beds, furniture, television, HiFi, pictures and personal mementoes. All bedrooms had locks to enhance their privacy. Staff had gone out of their way to make rooms personal with bright colours, sensory equipment and ornaments. Residents had access to hoists, slings and bath aids necessary for safe moving and handling practice. The equipment was kept within their room and care had been taken to minimise their visual impact. Staff had received training as 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 17 part of induction on using these aids. Specialist equipment had also been purchased to improve the quality of the residents’ lives. Further refurbishment was to take place and the large garden at the rear of the home was in the process of being made accessible for residents. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Efforts have been made to ensure there are safe, stable levels of staff. The staff know how to meet the residents’ needs by receiving comprehensive programmes of education. Staff are also supported in their work. EVIDENCE: Each member of staff was responsible for care, catering, domestic and laundry duties. Since the last inspection there had been a turnover of staff and as a result of increased personal care required by one resident there had been difficulties in meeting all the needs of the residents. This had been openly acknowledged by Sense. Efforts had been made however to address this. Additional funding had been obtained from the funding authority and reviews were taking place every 3 months. Additional staff had been recruited and there was now an additional 90 hours a week to meet this person’s needs. There were normally 3 to 4 staff during the day and 2 staff on wakeful duty. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 19 There were 2 vacancies for staff. The posts had been advertised. Staff were recruited correctly with an application form, 2 references and Criminal Records Bureau check. A new member of staff confirmed this had taken place and commented, “It is lovely here”, “I felt welcomed when I came here” and “I have found everyone very helpful and supportive”. Staff also spoke of the training and support provided to give them the skills to care and support the needs of the residents. Training had included a 12 week induction programme after which staff could study supported training in care (National Vocational Qualifications) of which 40 of the staff had obtained this. Four staff had completed NVQ and a further 2 were studying for NVQ level 2. In addition, training had also included British Sign Language, first aid, understanding and managing challenging behaviour, medication, fire safety, sexual awareness, safeguarding adults and physiotherapy. Throughout our inspection visit we saw staff taking time, in an unhurried manner to communicate, support and encourage residents in a calm and sensitive manner. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 37, 38, 40 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The day to day needs of the residents are met by an experienced, committed management and staff team. There are safe management systems in place to ensure the home is well run. EVIDENCE: The acting manager has been in post since December 2006. She was a registered nurse and had been a manager with many years experience at a previous Sense home. She was working to obtain a management qualification and would be applying to us to become the registered manager. Staff felt confident in the management style and commented, “I find the manager approachable and supportive”. There were regular staff meetings. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 21 There were detailed policies and procedures, which also referred to equality and diversity. Throughout the inspection we saw staff understanding and respecting the complex and diverse needs of the residents in the home. The manager was also aware of the Mental Capacity Act 2005. Sense also made monthly unannounced monitoring visits and detailed reports had been sent to the Commission. Records examined on the day of the inspection were available, well maintained and up to date. The home had a comprehensive and detailed health and safety policy together with detailed risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were regular tests of the fire system as well as regular fire drills. Essential equipment had also been thoroughly checked/serviced. The first aid box was well maintained and correctly stocked. Water temperatures were tested regularly. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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 Standard No Score 1 4 2 3 3 3 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 x LIFESTYLES Standard No Score 11 4 12 3 13 3 14 4 15 3 16 X 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 X 3 X 3 x 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. 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 YA34 Good Practice Recommendations Each member of staff should be given a copy of the General Social Care Council’s Codes of Practice. This will ensure that they know about their responsibilities when delivering care and support. 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN 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 38 Church Street DS0000032997.V342111.R01.S.doc Version 5.2 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. 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