Care Home: Walton Road

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What the care home does well 1 Walton Road is a large detached property that is ideally situated within easy reach of the Clacton town centre facilities. The house is well laid out and all bedrooms are spacious with en-suite facilities. The process of helping people to move into the home has been relaxed and well-organised allowing people sufficient time to adjust to their new surroundings. Preparations are well underway to encourage and enable people living at the home to experience a range of activities both within the home and the community. What has improved since the last inspection? This is the first inspection of this home. What the care home could do better: The carpets in some of the rooms, particularly the main sitting room, are badly stained. A solution will need to be found to ensure that people are provided with a floor covering that is able to be kept clean and odour free at all times. The home has no information available to show the range and extent of information that has been provided to each member of staff during their initial induction training. The home had still not provided staff with an ongoing induction-training programme based on the Skills for Care package. CARE HOME ADULTS 18-65 Walton Road 1 Walton Road Clacton on Sea Essex CO15 6DU Lead Inspector Brian Bailey Unannounced Inspection 5 & 18 December 2007 09:45 th th Walton Road DS0000070435.V356210.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 Walton Road DS0000070435.V356210.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. Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Walton Road Address 1 Walton Road Clacton on Sea Essex CO15 6DU 01206 224100 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) walton@consensussupport.com www.concensusupport.com Consensus Support Services Ltd Mr Kevin John Filby Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service: Care Home - PC to service users of the following gender: Both Whose primary care needs on admission to the home are within the following categories: Learning Disability - code LD Date of last inspection None, new service Brief Description of the Service: 1, Walton Road is a care home owned by Consensus Support Services Limited, which is the learning disabilities part of Caring Homes Ltd., a private company. The home is a large detached house situated within walking distance of Clacton town centre. This is a new home that was first registered to accommodate and support six people in August 2007. The service supports adults with complex needs to live in an ordinary home environment. Information about the service may be obtained by contacting the manager. The fees that are charged each week for accommodation at 1 Walton Road were not available at the home on the day of the site visit. However, items that are extra to fees include hairdressing, toiletries, chiropodist, and personal items such as magazines. Inspection reports will be available from the home and from the CSCI website at www.csci.org.uk Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key unannounced inspection looking at the core standards for the care of adults. This report is based on a range of information that has been accumulated from our inspection records, which includes a detailed assessment of the home completed in June 2007 by the manager, two site visits to the home that took place on 5th and 18th December 2007, a tour of the property, discussions with the manager, staff and the people that live at the home, observations, questionnaires issued by us and a sample of many of the records kept at the home. This was the first inspection of 1 Walton Road since it was registered by us in August 2007. On the days of the visits there were three support staff on duty plus the manager and four people in residence. The inspector was given every assistance from the staff and people living at the home. From observation, discussion and the information available, it was evident that in the short time the home has been open, the manager and staff have continued to develop the home and introduce new ideas and experiences to benefit people living at the home. At this inspection, 33 National Minimum Standards and the outcomes of these for people living at the home were assessed. 30 areas were assessed as meeting the required standard and 3 areas of shortfall were identified resulting in requirements and a recommendation. What the service does well: 1 Walton Road is a large detached property that is ideally situated within easy reach of the Clacton town centre facilities. The house is well laid out and all bedrooms are spacious with en-suite facilities. The process of helping people to move into the home has been relaxed and well-organised allowing people sufficient time to adjust to their new surroundings. Preparations are well underway to encourage and enable people living at the home to experience a range of activities both within the home and the community. Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 6 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. Walton Road DS0000070435.V356210.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 Walton Road DS0000070435.V356210.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): 1, 2, 4 and 5. Quality in this outcome area is good. The home ensures prospective individuals and/or their relatives have the information they need to make an informed choice about where to live. The home ensures people are admitted on the basis of a full assessment. Prospective individuals are given the opportunity to visit and “test drive” the home as part of the transitional process. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s Statement of Purpose and Service User Guide were up to date and available at the home. The service user guide has been produced as an easier to read version that has text as well as images to help people with understanding the content. Feedback from the manager and staff confirmed that trial stays are available and prospective individuals and their relatives are encouraged to visit to meet the staff and look at the facilities. Staff confirmed that the four people at the home did make a series of visits before moving in. Prior to the home opening, four staff also spent time with the four people at their previous address with the intention of making the transition to Walton Road as smooth as possible. Advocates also visited Walton Road with the person they were supporting. The care records of two people were checked and these contained pre admission/transition assessment reports, which covered a wide range of Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 9 physical, social and emotional needs. The records also included personal profiles that provided useful information about their health care needs. Contracts between Consensus Support Services Ltd and people at the home are provided. Walton Road DS0000070435.V356210.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): 6, 7, 8 and 9 Quality in this outcome area is good. People at the home are enabled and encouraged to contribute to the daily life and routines of the home. People could be certain that their care plans were sufficiently detailed to enable staff to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The care records of two people were examined on the day of the visit and both contained a wide range of detailed information. The care plans were well laid out, consistent in style and easy to understand the identified care need and how this was to be achieved. There were clear guidelines for staff on how to implement the care needs identified. Both care plans looked at had evidence that they are reviewed. It was evident from the records, discussions with staff and from observation, that the staff had the necessary skills, motivation and experience to communicate effectively with people and to support them appropriately. Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 11 People living at the home receive either one-to-one or two-to-one support, therefore staffing levels are good and this maximises the time staff have got to listen and support them in making choices. From discussion with staff and from observation, people are encouraged to be as independent as possible and to make choices. Walton Road DS0000070435.V356210.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): 12, 13, 15, 16 & 17. Quality in this outcome area is good. People are encouraged and enabled to maintain contact with friends and family and to participate in a range of activities that are interesting, stimulating and appropriate. People benefit from being provided with a healthy and balanced diet. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The four people living at the home have only recently moved to Walton Road and therefore staff were still in the process of identifying the requirements of people and the facilities available. The home employs a support worker who also has responsibilities as the home’s activities coordinator. From discussion, it was evident that all staff are being involved in a process to explore with the people, the level of their individual skills, their interests and likes and dislikes. Staff have started to identify a range of activities and experiences for each person and have had to Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 13 explain why they believe their suggestions would be suitable. The activities coordinator explained how they are still discovering abilities of people that were apparently unknown previously. It was clear that staff are determined to offer choice, experiences and opportunities and that there plans to achieve this are well underway. Three staff spoken with were of the opinion that an additional computer would be a valuable asset for the home. This would benefit some people living at the home as they would be able to improve their communication skills through the use of specialist software. Bus and train passes for people are being obtained and staff are planning to make use of these by enabling people to access the immediate and wider community. For some people these will be new experiences and therefore staff spoke of their contingency plans should a person not find the experience acceptable. Friends and family are being encouraged to make contact and for visits to be made, but some of these are still at an early stage. The home has the use of a vehicle suitable to take everyone out for trips. The home has a well-equipped domestic style kitchen. Food stocks were excellent and staff spoke of ensuring that people at the home are able to participate in the buying of food for the home in local shops. Menus were available, which showed that good ranges of meals are provided. Staff spoken with considered the quality of food and the variation of meals provided is good. Walton Road DS0000070435.V356210.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): 18,19 and 20. Quality in this outcome area is good. People’s care needs are well documented and individual risk assessments are in place so that staff are clear about what is required and how the persons needs are to be met. Procedures are in place to ensure that medication is administered appropriately. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information was recorded on care records to indicate the way each person preferred to have their personal care needs met. Each person has an en suite bath so that they may be assured of privacy. The home employs a mix of male and female staff. Care records for each person contained details of their health care needs. There are Health Action Plans on file and charts to record their weight and any appointments for health care professionals. These were up to date. Care plans examined contain relevant information about prescribed medication. The home operates a monitored dosage system. There were no controlled drugs in use at the present time. There are currently no people at the home with the capacity to self medicate. All four people have prescribed Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 15 medication, which are stored in a purpose bought lockable metal cabinet. No homely remedies are kept at the home. The Medicine Administration Record (MAR) sheets were examined on the day of the inspection visit, these were accurate and up to date. Staff responsible for the administration of medication have been provided with appropriate training. Certificates confirming their training were available on the staff files. The home takes the administration of medication seriously and has procedures in place should a staff member make a mistake. Walton Road DS0000070435.V356210.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): 22 and 23 Quality in this outcome area is good. People at the home are able to live in a safe and secure setting. Staff training and procedures are in place, which are designed to protect people living at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A copy of the home’s complaints procedure was available and is included in the service user guide. One complaint had been recorded, which was from a neighbour and the manager was able to demonstrate that the matter was dealt with appropriately. Records examined show that the home has policies in place for the protection of vulnerable adults (POVA). There is a whistle blowing policy in place so that staff may be assured that they will be protected if they feel the need to raise concerns about practices. Records available show that the home carries out POVA checks and Criminal Records Bureau (CRB) enhanced disclosure checks. Staff receive training on Adult Protection issues. Walton Road DS0000070435.V356210.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): 24, 26 and 30. Quality in this outcome area is good. Good standards of accommodation and facilities are provided to enable people living at the home to enjoy attractive surroundings, comfort and privacy apart from those areas where the carpets are badly stained. This judgement has been made using available evidence including a visit to this service. EVIDENCE: 1 Walton Road is a two storey detached property that is situated in a quiet residential area of Clacton. A partial tour of the house was carried with the manager and this showed that the home is being maintained to a good standard. The home presents as a light, modern and cheerful place to live. The quality and standard of furnishings and decoration is good. All bedrooms are for single use and have en-suite facilities. Bedrooms seen were clean, well equipped and individual in appearance. There is a good standard of cleanliness throughout the building, although some carpets, particularly in the lounge, were badly stained and were in the Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 18 process of being professionally cleaned during the inspection visit. Two weeks later at the second inspection visit the lounge carpet was seen to be badly stained again. A solution to this problem needs to be found so that people at the home can have a more suitable environment to use. The home has a lounge, which is large enough for five people, has comfortable chairs and a television and a separate dining room. The laundry facilities were clean and appropriate for the size of the home. Lockable cupboards are provided for cleaning materials. The kitchen is a modern domestic fitted kitchen and was clean, well maintained and is used by some of the people. There is a small private garden that people can access. Staff records examined show that staff receive training on Health & Safety matters including Manual Handling, Food Hygiene and Infection Control. There is no car parking facilities within the grounds of the home although free street parking is available. Walton Road DS0000070435.V356210.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): 32, 33, 34, 35 and 36. Quality in this outcome area is adequate. People at the home benefit from being supported by a team of experienced and motivated staff that can meet their needs but they may be at risk if staff have not received adequate induction training. People are protected by the home’s recruitment procedures. This judgement has been made using available evidence including a visit to this service. EVIDENCE: From information provided by the manager, 5 of the 11 support staff have a National Vocational Qualification at level 2 and 2 staff are in the process of taking a NVQ 2. This means that the home is on course to meet the recommended target for qualified staff during the first year of operation. Staff rosters were seen and staff confirmed that it is general practice to have three staff on duty during the day and two staff at night on waking duty, which is considered sufficient. The home has an appropriate recruitment procedure in place. Three staff files were checked. The files were well organised and contained all the relevant documents including application forms, job descriptions, two references, a Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 20 photograph and proof of identity, Criminal Record Bureau (CRB) disclosure checks at enhanced level, supervision records, and training certificates. Staff spoken with confirmed that they are well supported and receive supervision. Staff training records were well maintained and easily retrieved for checking. Training records showed and staff confirmed that they receive an initial induction into the home. There was no evidence available to support this though. The manager was advised to keep a list of all the topics covered during the initial induction, and for these to be dated and signed for when the information had been given to the new member of staff. A more in-depth induction using the Skills for Care common induction standards is to be provided but this was not available yet. Information provided to us shows this issue is part of their plans. Staff said that they considered 1 Walton Road to be a happy home and that they enjoyed their work. Walton Road DS0000070435.V356210.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): 37, 39, 40, 41 and 42. Quality in this outcome area is good. People that live at the home can be confident that the manager and staff team run the home effectively and have policies and procedures in place to protect them. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There had been a change of manager since we first registered the home in August 2007. The current manager has a number of years experience both as a carer and as a manager. He has completed both the Registered Manager’s Award and a National Vocational Qualification level 4 in care. An application for registration as the manager will be required to be submitted to us. The home has a good range of up to date policies and procedures, which were available in the office for staff. As the home has only been operating for a short time since registration, a Quality Assurance system to obtain feedback Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 22 about what people think of the service had not been put into place yet. Evidence was available to show that team meetings are held at regulqar intervals. A minutes show that a wide range of topics are discussed that include the running of the home and needs of people living at the home. However, information provided by the manager in the home’s Annual Quality Assurance Assessment (AQAA) shows that this is there intention in the near future. The assessment states under the heading, plans for the next 12 months, “Implementing a system of monitoring the quality of the provided service on a monthly basis as an additional tool to the reguslation 26 visits” and “Service users, stakeholders and other professionals survey to be in place” CSCI gave out surveys in November 2007 to gauge what people think of the service. We received two back from people that live at the home. They were helped to fill in the forms by their support workers. These indicate that people were given information about the home; they were enabled to visit prior to deciding to live there and are given choices about what they want to do each day. Records showed that the home has good compliance with Health & Safety (H & S) matters. Staff had been provided with some of the relevant H & S training and certificates were available to confirm that systems and equipment have been checked. The home has a current liability insurance certificate, which expires on 15/4/08. Walton Road DS0000070435.V356210.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 3 2 3 3 X 4 3 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 3 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 2 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X 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 X 3 3 3 3 X Walton Road DS0000070435.V356210.R01.S.doc 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 YA30 Regulation 23 (2)d Requirement Timescale for action 01/02/08 2 YA35 18 (1) © i A solution must be found that overcomes the problem of soiled carpets, which make for an unpleasant environment for people at the home. Evidence must be available to 01/03/08 show that all staff have been provided with adequate induction training that equips them to care for the people living at the home. 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 YA32 Good Practice Recommendations The manager should aim to ensure that a majority of staff have been trained to National Vocational Qualification level. Walton Road DS0000070435.V356210.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Walton Road DS0000070435.V356210.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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