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CARE HOME ADULTS 18-65 2a Guildford Road Chertsey Surrey KT16 9BJ Lead Inspector Kenneth Dunn Unannounced Inspection 16th February 2009 09:30 2a Guildford Road DS0000013481.V374016.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 2a Guildford Road DS0000013481.V374016.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. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2a Guildford Road Address Chertsey Surrey KT16 9BJ 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) 01932 568553 Welmede Housing Association Ltd Mrs Susan Narriman Davies Care Home 6 Category(ies) of Learning disability (0), Physical disability (0) registration, with number of places 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care home only (PC) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Learning disability (LD) 2. Physical disability (PD). The maximum number of service users to be accommodated is 6. Date of last inspection 29th August 2008 Brief Description of the Service: 2a Guildford Road is a detached property situated off of the main road and within walking distance of Chertsey town centre. The home is owned and managed by Welmede Housing Association, with the staff team employed by North East Surrey Primary Care Trust. The home provides accommodation and care for up to six people who have a learning disability, four of whom may also have a physical disability. There are currently six service users living at the service. The service is wheelchair accessible throughout. The accommodation is a lounge-dining room, kitchen, laundry, toilet and one bathroom. All bedrooms are single occupancy and none are en-suite. The home has the use of its own vehicles to access activities and local amenities and has limited parking to the side of the building. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission has, since the 1st April 2006, developed the way it undertakes its inspection of care services. The inspection of this Care Home for Younger People was an unannounced Key Inspection and was the second site visit of this service in the current inspection year 2008/2009. Regulation Inspectors Mr Kenneth Dunn undertook the site visit. A member of staff requested that the people living at the home prefer to be known as residents therefore this term of reference is used throughout his report. The inspector looked at how well the service is doing in respect to the National Minimum Standards for Care Home for Younger Adults and how the service has implemented and undertaken the requirements and recommendation from the previous inspection report 29th August 2009. The site visit took into account detailed information provided by the registered provider and the manager and any information that Commission for Social Care Inspection has received about the service since the last inspection. Documents sampled during the inspection included the home policies and procedures and certificates from professional organisations or contractors. The inspector would like to thank the registered provider and registered manager for their time, assistance and hospitality during this inspection. The fees for the home are £1,375.00. Items not covered by the fee, include hairdressing, personal items, clothing, toiletries and some holidays. Activities are paid out of the amenity fund. The quality rating for this service is now two star. This means the people who use this service experience a good quality outcomes. What the service does well: The home has developed and undertaken a full review of the environment and services it provides. Contact with family and friends are encouraged and advanced. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 6 The registered providers complied with given requirements under the Care Homes Regulations within the given timescales. Returned quality assurance questionnaires indicated a high level of satisfaction with the home and the services they received. The residents of this home are now enjoying a full active lifestyle. Further questionnaires returned to the service from, relatives and visiting professionals revealed the high level of care and support offered to the residents. The home has demonstrated that the care needs of the current service users living at the home are well catered for and met. The documentation of individual care plans are easy to read, gives the reader a full picture of the residents likes and dislikes, communication needs and risk assessments. Observations of care staff interaction with the residents indicated that they are treated with dignity and respect. It was also observed that great care was taken in respect of the residents personal belongings and standard of cleanliness in bedrooms ensured individuals lived in a well-maintained environment. The staff on duty demonstrated a good grasp of Equality and Diversity. What has improved since the last inspection? What they could do better: The registered provider must ensure that appropriate support systems are maintained for the successful return of the registered manager to full time hours. The registered provider must ensure that the successful improvements the service has achieved is maintained and continues to improve the quality of life offered to the residents. 2a Guildford Road DS0000013481.V374016.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. 2a Guildford Road DS0000013481.V374016.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 2a Guildford Road DS0000013481.V374016.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): Standard 2 was assessed during the site visit on the 29th of August 2008. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The policies and procedures in place ensure that any prospective residents will have a full assessment of their needs completed prior to them being offered a place in the home. EVIDENCE: Please refer to the previous inspection report dated the 29th of August 2008. 2a Guildford Road DS0000013481.V374016.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 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents assessed and changing needs are reflected in their support plans, and they are encouraged to make decisions about their lives with assistance. Residents are supported to take risks as part of an independent lifestyle. EVIDENCE: A random sample of four support plans was undertaken as part of this site visit. In line with a requirement from the previous inspection report (29/08/2008) the support plans sampled now contain a good deal of information about resident’s assessed needs, the arrangements for meeting those needs and specific goals which had been agreed with residents. All relevant areas were covered including health and personal care needs, mobility, activities and social interaction, and educational activities. The plans sampled demonstrated that they are now regularly and thoroughly reviewed by staff and residents had participated in these reviews. There is good evidence that the residents are fully supported and encouraged by staff to make decisions about their lives. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 11 Residents are encouraged to take appropriate risks and are given good information and guidance on which to base decisions. In line with a requirement from the previous inspection report (29/08/2008) the risk assessments on file have been updated reviewed on a regular basis. The risk assessments were detailed and informative providing details of activities and tasks that the residents participate in. The reviewed risk assessments now provide clear guidance for staff to follow in order to minimise any potential risk to a resident of the groups as a whole. 2a Guildford Road DS0000013481.V374016.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 12, 13, 15, 16 and 17 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The residents now benefit from updated support plans that are designed to promote and enabled staff to meet the assessed needs of individuals. Within the support plans residents are encouraged and supported to identify their goals, and aspirations and work to achieve them. Individuals are able to make choices in accordance with their abilities and are provided with balanced diet in pleasant surroundings and in an unhurried way. EVIDENCE: A random sample of support plans of four residents was undertaken as part if this site visit. In line with a requirement from the previous inspection report (29/08/2008), the service has undertaken a series of reviews of all support plans. The residents are encouraged to live a full and active life and to partake in age related activities such as going to the having meals out attending college of further education, art and crafts, swimming, bowling and going to a cinema club. The random sample of resident’s individual records and in discussion with care workers it was documented that the residents are encouraged to make friends 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 13 outside of the home and to keep in touch with their friends and families as they wish. The new kitchen is a good environment to prepare healthy and nutritious meals. The menus have been designed around the favourite meals of the residents. A member of staff stated that the meals are always very flexible and different options are always made available if residents do not want the meals being offered. 2a Guildford Road DS0000013481.V374016.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): Standards18, 19 and 20 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The resident’s health, wellbeing and welfare were being effectively met. The medication procedures are robust and if correctly implemented should safeguard the residents living in the home. EVIDENCE: Discussions with staff and a random review of four care plans indicated that individual residents received the agreed personal care and support as directed in the care plans. Physical and emotional needs of individuals identified in their care plans are also met. The care plans are now being regularly reviewed on a regular basis, visits to the doctor dentist, and dietician are carried out on an as required basis. The daily care notes of the residents are well documented dated and signed by the key worker or other care worker as necessary. A review of the medication records demonstrated that medication is being administered within the home’s policy and guidelines of administration of medicines. However the specimen signature of staff working in the home did not accurately reflect the staff engaged in the process of medication administration. Please refer to the requirement section of this report. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 15 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 16 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 were assessed during the site visit on the 29th of August 2008. People who use the service experience good quality outcomes in these areas. This judgement has been made using available evidence including a visit to this service. The resident’s rights are respected and supported by a robust complaints system and well developed safeguarding policies and procedures. EVIDENCE: Please refer to the previous inspection report dated the 29th of August 2008. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 17 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, 27, 28 and 30 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The refurbishment and the physical layout of the home should now enable the residents to live in a safe and comfortable environment, which encourages independence. EVIDENCE: There has been a considerable improvement within the general environment of the home. The kitchen has been fully completed to a good standard and offers a homely area to prepare meals and snacks. The bathroom has had a full refurbishment and again is finished to a good standard. In addition to the bathroom the service have fitted a new shower room, which was described as being a great bonus for the residents. The resident’s bedrooms have benefited from a make over with new furniture and decoration, on the day of the site visit the service took delivery of the final items of resident’s furnishings. The bedrooms are personal and individual. The staff have developed a series of risk assessments to ensure that the residents are safeguarded. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 18 The carpets have been recently professionally cleaned; unfortunately the sitting room and hall carpet were still heavily stained and will require being replaced or regular deep cleaning. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 19 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 and 35 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The resident’s benefit from a staff group who are trained, skilled and in sufficient numbers to support them effectively. The homes’ recruitment policy and the training given to care workers ensure suitably selected and qualified staff meets the residents needs. EVIDENCE: A random review of care workers training files indicated the staff are encouraged and enabled carers to undertake all relevant qualifications to successfully support the residents. The staff group support and assist the residents to achieve their agreed care and social needs. Review of the staff rota indicated that adequate numbers/skill mix of care workers are on duty over any twenty-four hour period to meet the needs of the residents. The home has a robust set of recruitment policy and procedure, based on their equal opportunities policy that has the needs of the residents at its core. Review of staff files demonstrated Schedule 2 of the Care Homes Regulations 2001 (Amended) was being observed by the home. In line with a requirement from the previous inspection report (29/08/2008), the service completed a full audit of staff files; as a result any areas where gaps were previously 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 20 highlighted have been discussed with the staff in question. The staffs were required to explain the gaps and to list and document the gaps and sign the resulting documents. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 21 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 and 42 were reviewed as part of this site visit. People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The management and administration of the home is based on openness and respect. The home has an effective quality assurance system in place. EVIDENCE: The registered manger has recently returned to work after a long period of illness. The manager stated that she is following a graduated return to work programme and is currently working very limited hours. The manager is being supported by a manager from another care home within the Welmede Housing Association. In addition the registered manger has the support of a deputy home manager. The service has clear evidence that Welmede Housing Association undertake monthly regulation 26 self-monitoring visits. A review of the regulation 26 visit indicate that all aspects of the home are reviewed in order to maintain and develop a high level care and satisfaction. In addition to the regulation 26 visits the service undertook a series of quality assurance questionnaires the most recent was completed in November 2008. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 22 The questionnaires were distributed to a wide group of interested people. The residents, their families, care managers, health care professionals and people who visit the home professionally on a regular basis such as the activities coordinator and the “music man”. A review of the returned questionnaires provided evidence of an improvement in the service and a good overall satisfaction with the service and the services it is providing. Samples of health and safety certificates were inspected and seen to be in order to ensure so far as is reasonably practicable, the health, safety and welfare of the residents and staff. The latest gas and electrical installation checks were sampled, and the home’s insurance certificate was displayed and up to date. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 23 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 2 3 4 5 CONCERNS AND COMPLAINTS Standard No Score 22 23 X X X X X X X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 3 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 34 35 36 LIFESTYLES Standard No Score 11 12 13 14 15 16 17 X 3 3 X 3 3 3 X 3 3 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 DS0000013481.V374016.R01.S.doc Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 2a Guildford Road Score 3 3 2 X 3 X 3 X X 3 X Version 5.2 Page 24 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. 1 Standard YA20 Regulation 13(20 Schedule 3.3(I & k) Requirement The registered provider must ensure that accurate samples of staff signatures engaged in medication administration is kept up to date. Timescale for action 16/03/09 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 YA30 Good Practice Recommendations The registered provider should ensure that the carpet in the communal areas are kept clean and free from heavy stains. 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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 2a Guildford Road DS0000013481.V374016.R01.S.doc Version 5.2 Page 26 - 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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