Inspection on 04/08/05 for 1 Butler`s Drive

This inspection was carried out on 4th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

1 Butler`s Drive 25/05/06

1 Butler`s Drive 08/12/05

1 Butler`s Drive 10/03/05

1 Butler`s Drive 10/08/04

1 Butler`s Drive 06/01/04

1 Butler`s Drive 18/11/03

Similar services:

Flint House

The Ley Community

Yeldall Manor

21 High Street

Vale House

Chestnut Walk

The Old Vicarage

Cherwood House Care Centre

Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 1 Butlers Drive 1 Butlers Drive Carterton Oxfordshire OX18 3HA Lead Inspector Delia Styles Announced 04 August 2005 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 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 Stationary 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. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 1 Butlers Drive Address 1 Butlers Drive, Carterton, Oxon, OX18 3HA Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01993 844923 01993 844432 Harry Watts Linda Eastwood Care Home 4 Category(ies) of Learning Disability (1); Mental Disorder, registration, with number excluding learning disability or dementia (1); of places Alcohol dependency, past or present (2) 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: The total number of service users that may be accommodated at any one time must not exceed 4. The above categories relate to four named individuals and the Commission will need to review any changes to the above. Date of last inspection 10 March 2005 Brief Description of the Service: The home is situated close to Carterton town centre and its facilities. Three doctors surgeries provide medical services and chiropody, dental and opticians are available locally. Residents accommodation is in a detached house, linked by a covered walkway to the Robert & Doris Watts Care Home for older people next door. The home was converted from private domestic use to a care home for younger adults in 2003. Because of the domestic nature of the house, it is only suitable for residents who are physically independent and who do not need continuous help and supervision from staff. There are three spacious ground floor rooms, two with en-suite wash basins and toilets and one with separate facilities. There is a shower on the ground floor. A conservatory provides a communal room, overlooking a small patio and garden at the rear of the house. The first floor has a sitting room, bedrooom and bathroom with an over-bath shower. Residents do not have their own kitchen facility, but meals are provided from the Robert & Doris Watts Home. Residents of Butlers Drive can join the residents in the adjacent home for their meals and social events as much or little as they wish. Access to the home is via the Robert & Doris Watts building. The laundry for both homes is housed in the former double garage, off the linked walkway. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection of the home that was undertaken on the same day as the announced inspection of the adjacent care home - 1 Butler’s Drive is effectively an annexe to the Robert & Doris Watts Home. The inspection lasted eight hours. The inspector toured the building, spoke with three of the four residents, three staff members and the home’s manager, deputy manager and the senior care staff member who has key responsibilities for 1 Butler’s Drive and the residents. Residents’ care records were looked at. The home proprietor was also available for discussion during the day. The inspector received comment cards about the home and people’s views about the care and facilities from three of the four residents, one relative and one visiting doctor. The inspector fed back to the managers at the end of the day. What the service does well: What has improved since the last inspection? The ground floor shower has been replaced and is maintained in working order. The patio garden area between 1 Butler’s Drive and the Robert & Doris Watts Home has been improved by planting scented herbs and plants in the raised garden bed. Fencing panels around the garden have been strengthened. Locks have been fitted to the rooms of residents who requested them at a previous inspection. The home now has a full-time person who oversees the administration of residents’ personal finances (for those whose finances are dealt with by social services) and is going to improve the systems used to record the accounting and financial procedures for the home. The activities worker’s hours have also increased and she is working with residents and carers in both homes, to develop a new activities programme to suit the wishes of individuals and groups of residents. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 6 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. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 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 Standards Statutory Requirements Identified During the Inspection 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 All four residents have lived in the home for more than a year and there is an ongoing process to make sure their individual aspirations and needs are met. EVIDENCE: Residents spoken to have all had regular meetings with, and support from, other health and social care workers to ensure that the home regularly reviews and discusses their care with them and the extent to which the home is meeting their individual needs. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7, 8 & 9 Residents are enabled to make decisions about their lives and are consulted about, and take part in, the social life of the home as much or as little as they wish. EVIDENCE: Residents and key staff make sure that individuals are able to do what they want in terms of planning shopping trips (if they need help), involvement in helping around the home (if they wish) and regular meetings with family and community support workers. One person’s care plan should be updated to include reference to his preferences about access to his room by cleaning staff. Residents’ care plans included risk assessments about specific potentially ‘risky’ activities such as smoking, unaccompanied trips from the home and excessive exposure to sun. Residents had agreed and signed their care plans and risk assessments. Residents had been given a questionnaire about the home and facilities to complete in March 2005 and the responses had been analysed and acted upon by the home’s managers, where possible. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14, 15, 16 & 17 The home’s staff provide a range of social activities and opportunities for resident’s individual self-expression. The life of the home is regularly discussed with residents to try to ensure that each individual has variety and interest in their life. EVIDENCE: The current residents of the home join in with social activities and mealtimes with residents in the Robert & Doris Watts Home as much or as little as they like. All appreciate the privacy and individuality of their own rooms and ‘separateness’ from the adjoining home. The activities co-ordinator has increased her hours and is available to residents in both homes. She is enthusiastic and creative, and ensures that resident’s individual abilities and skills are suited to the range of outings and activities organised in the home. Residents’ ‘keyworker’ staff are involved in discussing residents’ personal preferences about the pattern of their day and access to their rooms. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 11 Residents discuss and agree individual ‘house rules’ in their contract, for example letting staff know if they are going out and whether they will be back for mealtimes, and alcohol and smoking restrictions. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 18, 19 & 20 The arrangements in place in the home result in residents feeling safe and well cared for by staff. EVIDENCE: Residents’ care records indicated that residents had regular visits from support workers and care managers. Residents have physical and mental health assessments and their medication reviewed regularly. From the three residents’ comment cards received, and talking to three of the four residents and staff, it was apparent that residents felt well cared for and secure in their home. Residents able to manage their own medication are encouraged to do so, and staff maintain regular checks to ensure that medications are stored safely and that residents take their medicines as prescribed. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 & 23 The systems in place for consulting with residents to get their views about the home and facilities are good. Procedures are in place to safeguard residents from abuse, neglect and self-harm. EVIDENCE: A questionnaire was given to all residents for their views about the care and facilities in the home in March 2005. The completed questionnaires were analysed, and any specific concerns were discussed with residents, if they wanted to (residents could give anonymous replies). Individual resident’s care records show that the home’s manager and staff have taken steps to make sure that the risk of harm is assessed and discussed with each individual - for example the use of alcohol, and failure to take prescribed medication or eat a balanced and appropriate diet for their medical condition. A concern about a resident’s behaviour towards a visitor, raised with the inspector through a relative/visitor’s questionnaire, was discussed with the home’s manager and proprietor, who confirmed that the matter had been followed up with the persons concerned and had been resolved satisfactorily. There was a record of the concern on file. A resident contacted the CSCI about a delay in their access to their personal monies held by Social Services Money Management. This was followed up with the resident’s care manager, appropriate fund manager and the home’s staff, with a satisfactory outcome. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24, 25, 26, 27, 28 & 30 The home is very clean and resident’s individual rooms are homely and suit their individual needs. The proprietor has made some progress in improving the outdoor area for residents by tidying and improving the adjacent car park and grounds, and in the small shared garden at the rear of the home. EVIDENCE: The home is an adapted domestic, detached house, with a covered link walkway to the Robert & Doris Watts Care Home. The main entrance to the home is via the Robert & Doris Watts Home, through the walkway and to the back door of 1 Butler’s Drive. There is short ramped section of path, with a handrail, outside the back door. The car park area and waste ground adjacent to the home (visible over the dividing wooden fence) had been cleared of some of the accumulated discarded furniture, fridges, building materials and garden rubbish that the inspector recommended be cleared at the time of previous inspections. There was still an accumulation of paint pots, bicycles and discarded walking aids in the space between the link corridor and boundary fence. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 15 The proprietor had recently had a large bonfire to burn rubbish on the site and, following complaints from neighbours and the fire and environmental health officer, has agreed to stop this practice because of the potential fire and pollution risk to residents and neighbouring properties. The home is commendably clean. Residents’ rooms were all comfortable and homely and residents said they liked their rooms and they could be private in them. There was a freezer in the ground floor corridor area of the home because there is not enough space in the kitchen in the adjacent home. The freezer should be moved to an alternative storage space – residents’ accommodation and shared space should not be used for storing equipment or appliances that are not used by them or necessary in their home. The resident whose bedroom is on the first floor uses the first floor sitting room, this effectively providing self-contained accommodation. The ground floor conservatory is rarely used by the current residents, but has been used for staff training sessions or family meetings. Residents should always be asked by the manager for their agreement to the occasional use of this communal room by visitors or staff as it is the only shared space for residents and they should be consulted before it is used by visitors. There has been no action taken by the proprietor to provide a suitable wash basin within the laundry room. This was a requirement following the last inspection. Staff are provided with disposable gloves and protective clothing and said that they can wash their hands at a small wash basin accessible through the staffroom used by those who smoke, or a ground floor sink in what was the kitchen area in 1 Butler’s Drive. It is not appropriate for laundry staff to have to go into the residents’ shared accommodation to wash their hands. The requirement made at the last inspection is only partially met. Staff must have a suitable antibacterial hand rub solution to clean their hands, in addition to improved access to the hand washing facility off the staff room, if a wash basin with hot and cold water cannot be provided within the laundry. The laundry serves both care homes, and staff have to process dirty and infected laundry. Lack of proper hand washing facilities may put staff and residents at risk of cross-infection. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 16 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 & 35 Individual named staff members from the team for the adjacent home are allocated to provide support and care for the each of the four residents. This provides continuity of care for the residents and good communication between residents and staff. EVIDENCE: Staff and two residents spoken to were clear about who was their ‘key’ care worker and who to go to if they had any concerns. The current residents have lived in the home for some time, and it was evident that their individual needs were understood by staff and that there was a good relationship between them and staff. The current residents have a range of care needs and the home’s manager ensures that each resident has contact and support with staff from former care settings and health and social care workers, to make sure that the resident’s care and wellbeing is paramount. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 17 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 & 42 There is a ‘family atmosphere’ in this home that is the result of the commitment and support given by the managers and staff towards the residents and each other. EVIDENCE: From the comment card responses, conversation with staff and residents and observation of staff interacting with residents, it was clear that residents felt confident that the manager and staff listened to, and acted upon, their views about the home and any individual worries. Residents looked confident and comfortable, both in their own rooms and when in the adjacent home at mealtimes, in the garden or sharing in activities. Residents are consulted with daily about their preferences and to what extent they want to join in planned activities or social events with the residents in the Robert & Doris Watts Home. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 18 Residents’ health and safety is protected through the home’s policies and by their own awareness of, and agreement with, personal ‘contracts’ about dietary, medication and ‘no alcohol’ agreements. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 19 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 2 x 2 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x x x 3 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 1 Butlers Drive Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 3 3 x x 3 x H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 20 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA30 Regulation 16(2)(j) Requirement Provide adequate hand-washing facilities, accessible to staff, in the laundry. If a wash basin cannot be sited within easy reach of laundry staff in the laundry room additional infection safeguards must be adhered to, for example provision of suitable antibacterial hand rub solution. Timescale for action October 31st 2005 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. 2. Refer to Standard YA10 YA28 Good Practice Recommendations Individual’s preferences about their care/care instructions should be recorded in their care plans Find alternative storage area for the freezer and any equipment not required by residents of the home. Ensure that residents are consulted, and are in agreement, before the use of their communal room(s) by staff or visitors to the home. 1 Butlers Drive H57-H08 S48045 Butlers Drive V231572 040805 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Burgner House, Cascade Way Oxford Business Park South Cowley, Oxford OX4 2SU National Enquiry Line: 0845 015 0120 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. 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