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CARE HOME ADULTS 18-65 39 Denford Road Ringstead Kettering Northants NN14 4DF Lead Inspector Gary Robinson Unannounced Inspection 19/03/09 13.30p 39 Denford Road DS0000012768.V373333.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 39 Denford Road DS0000012768.V373333.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. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 39 Denford Road Address Ringstead Kettering Northants NN14 4DF 01933 461908 01933 460917 denisel@avens.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Avens Ltd Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Denise Lyford Care Home 12 Category(ies) of Learning disability (12) registration, with number of places 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 39 Denford Road Care Home is registered to provide personal care to male and female service users who fall within the following categories :- Adults with learning disabilities (LD) 12 39 Denford Road Care Home can accommodate a maximum of 4 service users who also have physical disabilities. The maximum number of persons to be accommodated at 39 Denford Road is 12 20th September 2006 Date of last inspection Brief Description of the Service: ‘39 Denford Road’ is a care home providing personal care and accommodation for up to twelve adults with a physical or learning disability. The care home is situated in a residential area in the Northamptonshire village of Ringstead, and the property has been adapted to accommodate the twelve adults in two units, each with six single bedrooms. Each bedroom has an en-suite toilet and washbasin. There is a garden and parking area for visitors to the rear and side of the building. A range of weekly fees is charged dependent upon the support required and the current tariff is available on request from the Manager. Additional costs are payable, for example fees for chiropody and hairdressing. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 stars. This normally means the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users. ’39 Denford Road’ was inspected following an unannounced visit made to the premises on the 19th of March 2009, with an additional visit made the following day to meet with support workers individually. The Manager is required to submit an Annual Quality Assurance Assessment document that contains current information about the service and how well it is performing. This information was taken into account, as well as information received since the last inspection. ’39 Denford Road’ was again inspected using the method of ‘case-tracking’. This means we looked at, in this instance, the standard of care received by four adults currently living at ’39 Denford Road’. We inspected records relating to the health, welfare, and support provided to those four adults, met with support workers, and inspected their living environment, including communal lounge and dining areas and, with their consent, their bedrooms. There was also an opportunity to review the day-to-day running of ‘39 Denford Road’ with the registered Manager and meet with the Responsible Individual for Avens Ltd, the Company that owns and runs this residential service. What the service does well: What has improved since the last inspection? What they could do better: Guidance and information for support workers is comprehensive but some pages of documentation relating to information about service users are printed out without any paragraphs and contain so much detail that it may be possible to overlook a key fact in the text. Some information was out of date, including the Commission’s address, and the last Manager’s name still appeared on some documents about the service. 39 Denford Road DS0000012768.V373333.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. 39 Denford Road DS0000012768.V373333.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 39 Denford Road DS0000012768.V373333.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 Quality in this outcome area is good. Service users’ needs are appropriately and thoroughly assessed so that they continue to receive a service best suited to them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Statement of Purpose and Service User Guide provide comprehensive, detailed information about ’39 Denford Road’, although some care is needed to keep these documents up to date, for example there is now a new registered Manager in post and the above documents still showed the name of the previous Manager; it is acknowledged that this oversight has since been corrected. These documents are available in written as well as picture symbol formats. Service user files contained detailed documentation, including assessments, reviews, and other pertinent information relating to their day-to-day care and longer term goals. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 6,7,9,10 Quality in this outcome area is good. Service users’ needs and preferences are reflected in their documented plan of care and this enables staff to provide the support they need in a sensitive, effective way. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Each service user has an agreed plan of care that sets out the support they need to enable them to maximise their independence and have enjoyable and fulfilling experiences. There is detailed guidance for support workers, including how to recognise and deal with changes in a service user’s behaviour such as, for example, when they may be anxious or distressed. Service users’ views are recorded and support workers were observed to consult them about daily living choices. Information about service users is appropriately stored, both electronically and in written form, in the staff office. Support workers adhere to a policy of confidentiality. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 10 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 12,13,15,16 & 17 Quality in this outcome area is good. Service users are encouraged and supported to be involved in community leisure and educational activities, as well as maintaining friendships and family contacts. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users regularly go out throughout the day, whether to visit a relative, go to the local pub, or attend a college course; it was evident that support workers continually create opportunities for service users to be able to go out. Equally, each service user’s personal preferences are respected; there is no expectation that they have to join in with an activity or go out. Each service user has an agreed activity programme, which reflects what they like to do. Service users and support workers take their meals together; with two separate dining rooms so that the needs of each service user can be appropriately met. The menu is varied, with meals prepared by a Cook. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 18,19,20 Quality in this outcome area is good. Service users get a service specific to their changing needs, ensuring their individual capability to live their life as they choose is consistently being supported. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is documentary evidence on service users’ files that they have appropriate and regular access to the healthcare professionals they need; for example, doctors, opticians, and dentists, as well as other specialists. Each service user has a designated ‘key worker’ who supports them and who is responsible for ensuring the plan of care is reviewed. Medication records, administration procedures, and storage of medication appeared in good order. An external Pharmacy conducts regular checks on medication and associated records. Service users’ personal appearance and demeanour supports the conclusion that their personal care is appropriately monitored and that they get the support they individually need with regard to personal hygiene and dress. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 22,23 Quality in this outcome area is good. Service users appear relaxed in the presence of support workers and other staff; this, and the training staff get, supports the conclusion that each person feels safe and protected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There is a complaints procedure with evidence that service users have used it to raise issues they were unhappy with; a record is kept of what was done to resolve these issues. Support workers have training on the protection of vulnerable adults and are clear about what they need to do if they suspect abuse is taking place. The interaction between individual support workers and service users appeared relaxed; it was evident that support workers listen to what service users say. For those service users whose communication is limited, support workers are also vigilant at picking up on non-verbal communication and responding in a sensitive, appropriate manner. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 24,25,26 & 30 Quality in this outcome area is good. ’39 Denford Road’ is kept clean, appropriately maintained, and service users are encouraged to personalise their room. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The premises were free from unpleasant odour and communal areas were found to be clean. The kitchen recently got a good rating for its hygiene standards. Décor in access corridors is satisfactory, if perhaps rather bland, with functional strip lighting in some corridors. Service users have chosen the colour they like in their room and each bedroom seen was personalised with belongings, favourite pictures and photographs, etc. Bedrooms are large, have en-suite toilets and washbasins, and service users seem to like their room. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Standards 31,32,33,34,35, & 36 Quality in this outcome area is good. Sufficient trained staff are employed to meet service users’ needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All new staff are appropriately recruited, with references taken up and a Criminal Records Bureau (CRB) clearance obtained before they take up their duties. Staff have attained the Learning Disability Award Framework (LDAF), a vocational qualification for staff working in this field. Staff are encouraged to work towards achieving their National Vocational Qualification in Care (NVQ) and of the three support workers asked at the time of this inspection, one held an NVQ Level 3, one an NVQ Level 2, while the other support worker, recently recruited, was expecting to start work on her NVQ Level 2 qualification. Support workers individually confirmed that they received good managerial support and were required to attend regular supervision support meetings with their team line manager. Examples of these records were on file. Each support worker, including the Manager and Deputy, presented as conscientious and knowledgeable about the needs of the service users. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 15 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 37,38,39,40,41,42,43 Quality in this outcome area is good. Service users benefit from living in a supportive environment that is effectively yet sensitively managed. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Since the last inspection a new registered Manager has been appointed and has worked effectively with the staff team to ensure service users are well cared for. Policies and procedures governing good practice and the running of ’39 Denford Road’ have been updated. It is evident from the enthusiasm of the Manager and Deputy that they have the best interests of the service users in mind. 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 16 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 3 2 3 3 3 4 X 5 X 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 3 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 3 LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 3 3 3 3 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 17 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 18 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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 39 Denford Road DS0000012768.V373333.R01.S.doc Version 5.2 Page 19 - 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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