Care Home: Strangers Way, 72 to 74

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What the care home does well Support plans ensure that people using the service are involved in their plans within their abilities. People using the service were seen to be happy and responded positively to their supporters. Choices are made using people`s individual and most appropriate way of communication. Independence is encouraged and supported.The service ensures that a wide range of day activities is available for people to choose from. People using the service are protected by safe working practices. They also said that ` I would talk to the Manager if I was not happy`. `Staff would support me to make a complaint`. Relatives confirm that `the service is meeting the needs of our relatives` we are pleased with the way our relative is supported`. The home is well maintained and safe. Support workers demonstrate that they have a sound knowledge of people`s needs and have been appointed using robust recruitment practices. The service is managed in the best interests of people living at the home. What has improved since the last inspection? The registered manager has with the staff team developed the person centred plans Support plans are regularly monitored, reviewed and updated. The shower room is now fully working. What the care home could do better: There were no requirements arising from this inspection. It is recommended the use of language that is age appropriate be discussed within staff team meetings. CARE HOME ADULTS 18-65 Strangers Way, 72 to 74 Luton LU4 9ND Lead Inspector Judith Roan Unannounced Inspection 11th June 2008 2.30 Strangers Way, 72 to 74 DS0000014974.V366334.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 Strangers Way, 72 to 74 DS0000014974.V366334.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. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Strangers Way, 72 to 74 Address Luton LU4 9ND 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) 01582 505013 01582 572397 h3080@mencap.org.uk Royal Mencap Society Mrs Catherine Tracey Snell Care Home 6 Category(ies) of Learning disability (6), Physical disability (6) registration, with number of places Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 15th March 2007 Brief Description of the Service: 72-74 Strangers Way provides accommodation to six people with learning or physical disabilities. It is situated on the corner of a main road in the Leagrave area of Luton. The home was created from two semi-detached three-bedroom houses. These were converted to provide two separate units (no 72 and 74): one with four bedrooms plus normal communal facilities and the other with two bedrooms, walk-in shower, kitchen and lounge. The units can only be accessed from the outside. The smaller unit (no 74) is intended for two service users who are able to live more independently and require a smaller staff input. The staff on duty work across both units. Night staff are based in no 72. There is off-road parking for three vehicles and the garden at the back of the house provides an attractive leisure space for all six service users. There is a good bus service along the main road and the railway station is about a mile from the home. The charges are £556 - £834. Strangers Way, 72 to 74 DS0000014974.V366334.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 star. This 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 people who use the service and their views of the service provided. This process considers the services capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting two people who use the service and tracking the care they receive through review of their records, meeting with them, the care staff and observation of care practices. People using the service living at 74 where individuals live more independently were both out on activities and were not visited on the occasion. We received two completed surveys from people who use the service, four from relatives and two fro health care professionals. People using the service said that they were well supported and that their needs were met’ One person said that’ staff could listen more’. Healthcare professional said that they had a ‘good impression of the service and that health needs are met’. Families were in the main positive about the support. Since the last key inspection in January 2007 we have undertaken an annual service review that confirmed good outcomes for people who use the service. The Inspector also received feedback from relatives, which was very positive. The homes registered manager also completed an Annual Quality Assurance Assessment (AQAA) a questionnaire required to be completed by CSCI. The inspection was unannounced and was undertaken during the afternoon and early evening lasting 4 Hours. What the service does well: Support plans ensure that people using the service are involved in their plans within their abilities. People using the service were seen to be happy and responded positively to their supporters. Choices are made using people’s individual and most appropriate way of communication. Independence is encouraged and supported. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 6 The service ensures that a wide range of day activities is available for people to choose from. People using the service are protected by safe working practices. They also said that ‘ I would talk to the Manager if I was not happy’. ‘Staff would support me to make a complaint’. Relatives confirm that ‘the service is meeting the needs of our relatives’ we are pleased with the way our relative is supported’. The home is well maintained and safe. Support workers demonstrate that they have a sound knowledge of people’s needs and have been appointed using robust recruitment practices. The service is managed in the best interests of people living at the home. What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Strangers Way, 72 to 74 DS0000014974.V366334.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 Strangers Way, 72 to 74 DS0000014974.V366334.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): 2 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 will have their needs assessed prior to admission to ensure that they can be met. EVIDENCE: Good information is available to people currently using the service to inform them about the home. People considering a move into the home would have access to the service users guide and enabled to ask questions through the assessment process. The AQAA confirms that assessment is undertaken prior to admission ‘ that involves gathering information from the person we are supporting, people who are important to them and any other professionals involved in their support (including assessments completed by care management)’. Assessments had been carried out for the people who currently use the service. These established that the service could meet their needs. Assessments are detailed and provide good information to develop support plans with individuals and their carers. Strangers Way, 72 to 74 DS0000014974.V366334.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): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Support plans clearly reflect the needs of people using the service. EVIDENCE: Comprehensive support plans are in place and those seen had recently been reviewed. The preparation for person centred plans (PCP’s) is ongoing with support workers taking additional training to facilitate these. Individual preferences are noted and support workers were knowledgeable about people’s needs and observed to be proactive in the support given throughout the inspection. It is evident that support workers use a wide range of communication skills to ensure that needs are understood and met. Changing needs are reassessed and appropriate support is supplied. Files contained detailed risk assessments and reports from annual reviews held with funding authorities. Daily recording evidences how needs have been met with important information being handed over between changing staff teams. In discussion with the resident they were able to confirm that they were consulted with and able to make decisions about their care. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 10 It was evident that there is good monitoring on how support plans are met and what progress has been made with individual goal plans. Support workers were seen to sensitive to people’s needs and were discreet in how personal care was undertaken. Person centred plans are in place with ongoing work to ensure that these remain an active documents are individual’s needs change. One person in their surveys said that support workers need to be more proactive in listening to a persons needs’. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 11 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): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service have their choices of lifestyles met. EVIDENCE: All people using the service have access to a range of daily day care opportunities, at day centres, college, employment or supported activities within the home. These activities promote equality and diversity the AQAA confirms that people are being supported to ‘ access religious worship each week and to join a small group from church during the week independently’. There is evidence that there is good communication between all parties with regular reviews with individuals to make sure that they are happy with the personal development opportunities and support available. On the day of the inspection a musician was working with three individuals who used the music to express themselves. These regular sessions encourage individuals to join in or to just enjoy the experience. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 12 People using the service are supported to choose the menu from a range of dishes that they like. Support workers prepare the meal, which is served in the family style dining room. Meals are used as opportunity for people using the service and staff to meet and share time together. The meal served at teatime was freshly cooked and was seen to enjoyed by all. The menu at the home is flexible and can accommodate people’s preferences and scheduled activities. There is a wide range of community activities to choose from and people using the service are supported to access local theatres, cinemas and groups. There is good contact with families with many calling on a regular basis. Families confirmed that they were always welcome at the home and that communication was positive. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 13 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): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Carers are proactive and support individual’s to access appropriate services to meet their healthcare needs. EVIDENCE: During the inspection it was noted that care and support is offered in a sensitive and flexible manner. People using the service have regular support to access healthcare appointments; support staff confirmed that there is good rapport with visiting healthcare professionals. Through inspection of the daily records it was evident that important healthcare records are recorded. The AQAA and evidence within the home demonstrates that through ‘person centred planning they support people in being more aware of their health needs and use health action plans to support people in doing this’. A survey from a healthcare professional said that needs are met and that they had a ‘good impression of the service’. Detailed communication strategies within PCP’s enable staff to be effective in supporting individuals. We observed in the main good practice. One point that was fed back to the registered manager was the need for appropriate language in relation to adults. It is recommended that the issue be discussed at a future team meeting to ensure that language is age appropriate. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 14 Management of medication was good and accurate records are maintained. A monitored dosage system is in place. Systems in place are in accordance with current good practice guidelines. Medication profiles were found in individual records with good information about its usage. The staff team manages medication with one member of team in turn taking responsibility for stock control and ordering. Medication was easily audited and regular checks are undertaken by managers to ensure that mistakes do not occur. Strangers Way, 72 to 74 DS0000014974.V366334.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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are protected by practices within the home. EVIDENCE: The service has a clear complaints procedure that is available for people using the service and their relatives. Support workers confirmed that have completed training on safeguarding awareness and understood the action they need to take if they are concerned. A recent disclosure by a person using the service has been handled appropriately with good outcomes for the individuals concerned. Additional and discreet support has been available to ensure that individuals are protected. It is clear that the systems within the home ensure that any safeguarding disclosure would be acted upon and dealt with professionally. People using the service who may have difficulty in stating their concerns are observed on a daily basis and any change in their normal behaviour would be investigated to ensure that they were happy and safe. Strangers Way, 72 to 74 DS0000014974.V366334.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): 24,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. A homely, clean and wellmaintained home meets the needs of people using the service. EVIDENCE: Bedrooms seen were clean, decorated to individual’s choice personalised and well maintained. Rooms contained personal belongings and were homely. The communal areas within the home provide space for people to spend time together if they wished in comfort. The three people at home at the time of the inspection had good access to all parts of the home and appeared at ease within the setting. Furnishings and fittings in the communal areas are comfortable and domestic in character. A ground floor wet room now meets the needs of people living at the home. The home was found to be clean and hygienic. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 17 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): 32,34,35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People using the service are fully protected by the robust recruitment practices of the organisation and are supported by a well-trained team of support staff. EVIDENCE: Two support staff were on duty to meet the needs of the three people at home. Work rotas are developed to meet the identified needs of people’s scheduled activities with additional support provided for access within the community. It was not possible on this inspection to review staff files, but in discussion with them it was confirmed that all relevant checks had been completed prior to taking up their appointment. Files have been at seen on previous inspections and no issues have ever been raised. Support staff talked about their training, which consisted of a full induction with good opportunities to develop their skills. The data provided through the Annual Quality Assurance Assessment AQAA document completed by the registered manager confirms that all staff have undertaken required training. It also confirms that ’Two staff hold National Vocational Qualification (NVQ) NVQ 3 in Promoting Independence and another four staff are undertaking NVQ 2 and 3’. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 18 Additional training is undertaken to meet specific needs of individuals. Support staff are well supported through regular supervision and meetings held at the home. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 19 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): 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 using the service have their best interests promoted. EVIDENCE: The service is well managed with a consistent staff team that ensures continuity in meeting the needs of people living at the home. Regular reviews held within the service ensure a holistic approach. A change in how views are sought is being considered. The AQAA states that ‘Mencap as a service provider organisation is currently undertaking a review of the way that we seek and gain feedback from the people we support. To date we have used accessible paper based questionnaires, but feedback from the people we support indicates that these do not always give the scope for people to comment on what is important to them in the support they receive. We are moving towards a more flexible process for facilitating and recording discussions with people based around what we believe to be best practice. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 20 The inspector was able to evidence that good records are kept within the home that protect individual’s finances. Health & safety records are maintained at the home and ensure that the environment is safe. The home no longer receives regular checks from environmental health but continues to work within the new standards. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 21 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 X 2 3 3 X 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 X 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 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 3 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 Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 22 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. 1. Refer to Standard YA18 Good Practice Recommendations It is recommended the use language that is age appropriate be discussed within staff team meetings. Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Eastern Region 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 Strangers Way, 72 to 74 DS0000014974.V366334.R01.S.doc Version 5.2 Page 24 - 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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