Inspection on 02/09/05 for 1 Springhead

This inspection was carried out on 2nd September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1 Springhead 03/02/05

1 Springhead 01/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Springhead (1) 1 Springhead Sutton Veny Warminster Wiltshire BA12 7AG Lead Inspector Roy Gregory Unannounced 2 September 2005 nd 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. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springhead (1) Address 1 Springhead Sutton Veney Warminster Wiltshire BA12 7AG 01985 840589 01985 840589 michaelwyatt44@tiscali.co.uk Mr Michael James Wyatt 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) Mr Michael James Wyatt Care Home 1 Category(ies) of LD Learning Disability (1) registration, with number of places Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 3rd February 2005 Brief Description of the Service: 1 Springhead, Sutton Veny, is the family home of the Registered Providers, Mr and Mrs Wyatt. It is a semi-detached house in a cul-de-sac on the edge of a medium sized village. This in turn is a ten-minute drive from Warminster, the nearest town. Registration is for one service user, who has her own purposebuilt extension to the home, with en-suite facilities. The establishment registered as a care home in 1998, when the service user reached adulthood; she had lived with them since she was a small child, under fostering arrangements. Registration was a means of enabling her to continue living with Mr and Mrs Wyatt. The latter do not propose to offer care to anyone else. At the present time, they do not employ any staff to assist them in their care of the service user. The service is therefore not typical of care home provision and several of the National Minimum Standards for care homes for younger adults do not apply. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection took place during the afternoon of Friday 2nd September 2005. During this time the inspector, Roy Gregory, talked with the providers Mr and Mrs Wyatt and reviewed documentation. The one service user was present the whole time. Her private accommodation within the home was also visited. Whilst this was an “unannounced” inspection, the timing was pre-arranged with the providers to ensure their and the service user’s availability, and to avoid an untimely incursion into domestic life. What the service does well: What has improved since the last inspection? What they could do better: No requirements or recommendations were set at this inspection. Returning to an issue raised by the providers in the past, the inspector gave advice about recent developments that may enable the opening of a bank account in the service user’s name. But their current management of her finances was considered safe and appropriate. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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 Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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) 1. (the key standard no. 2 is not relevant to tis service as there is no intention to admit any new service users). The service is designed and run around the needs of the existing service user, with no further admissions planned. There is appropriate information about the service offered to the user, which has been supplied to the user’s next of kin. EVIDENCE: Mr & Mrs Wyatt confirmed their intention to maintain the service purely for the existing service user, with no intention to offer accommodation to any other person, hence the inapplicability of most of these Standards. A letter from the service user’s family gave evidence that they have been supplied with a copy of the combined statement of purpose/service user guide, as recommended at previous inspection. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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 &9 Care is provided in line with a plan that is reviewed regularly and meaningfully. The service user is able to exercise decision-making in everyday life, and benefits from the carers’ appreciation of risk that does not impede participation in new or challenging experiences. EVIDENCE: The inspector saw that the high quality of care planning and three-monthly review seen at previous inspections was being maintained, along with appropriate liaison with other professionals. Mr & Mrs Wyatt were able to describe positive changes for the service user over time, which could be tracked through their written reviews, and which accorded with the inspector’s observations. The rapport between service user and the Wyatts includes a repertoire of non-verbal communication, by which the user is able to indicate wishes and decisions that her carers act upon. It remains the case that the service user can never be left unsupervised other than when in bed. The Wyatts like to facilitate the service user’s exposure to various experiences, provided safety is built in. Within everyday living, the service user has been helped to develop a number of successful transfers between chairs, bed and other equipment. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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) 11 - 17 The nature of care planning, and quality of relationships between the service user and providers, mean that the user enjoys access to planned and spontaneous activities that fit her individual wishes and needs. These provide for personal development and access to the wider community, as well as natural homely routines within the home. Provision of meals is excellent. EVIDENCE: The service user lives as one of the household, enjoying the intimacy and trust of a family life. She has a preferred routine within which she spends time both in the company of Mr & Mrs Wyatt, in the main part of the house, or in her bedroom, where she has personal treasures and audio-visual equipment. She is fully engaged socially, through participation in church and fellowship events, and on shopping trips. She has an annual holiday abroad with the Wyatts, and largely funded by them. During the week, the service user attends a day service. Mr & Mrs Wyatt valued this for the opportunities it provides the user for mixing with peers, as well as for the structured activities, therapies and one-to-one time offered. The Wyatts were concerned about mooted changes to day services, and were in touch with others affected in order to champion users’ rights. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 11 A record of main meals served showed considerable variety of home cooking. This year, Mr & Mrs Wyatt have produced fruit and vegetables themselves and incorporated these into the diet. The fine summer has enabled the service user to enjoy many meals outdoors, whilst they also like sometimes to buy meals when out. Competent assistance to eating and drinking was observed. Contact was being maintained with the service user’s family of origin. It was clear the service user had an understanding of this facet of her life when it was discussed. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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. (The key Standard no. 20 is not relevant at the present time). Personal support is provided in line with documented preferences, in a context of trust and familiarity. Healthcare needs are clearly recorded and managed, with full use of external consultation and guidance. EVIDENCE: Excellent interpersonal care was in evidence. Mrs Wyatt provides intimate care. Records show prompt attention and follow-up in respect of any possible illhealth indicators. Mrs Wyatt described three-monthly monitoring of one issue with the GP, which was confirmed in the written record of care. There is also a six-monthly dental check-up regime. The providers evidently maintain close working relationships with the various professionals with whom the user comes into contact. Mrs Wyatt, a trained and practising nurse, maintains vigilance about risk of pressure area damage. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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 service user and her family can feel confident in the home’s provisions for her security, and in the readiness and ability of the providers to respond to any concerns raised. EVIDENCE: The statement of purpose sets out how complaints may be made direct to the providers or to the Commission or the contracting authority. The user’s next of kin have this information. The providers are sensitive to any display of discontent on the part of the service user, and would see it as a priority to resolve this. The service user benefits from constant accompaniment by day and is monitored at night. The home provides well for security. The inspector examined the keeping of accounts of the service user’s personal monies. The improvements recommended at previous inspection have been implemented. An incident affecting the service user was notified immediately to the Commission and to the user’s family. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.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 - 30 1 Springhead provides a homely environment where the service user enjoys private and family facilities in comfort and in line with her needs. There is appropriate provision of specialist equipment, and standards of cleanliness are high. EVIDENCE: 1 Springhead offers a pleasant environment in a wholly domestic setting, which strikes as homely, clean and welcoming. The extension housing the service user’s room was designed and funded by the original placing fostering agency. The bedroom has been decorated and personalised in keeping with the user’s own tastes. It has been her room since 1985. The service user chooses periods of location in all the living areas of the home and the garden, with support. There has been lots of Occupational Therapy input over the years. Various adaptations and equipment have been put in place, including specialist toilet adaptation to maximise independence and dignity, and the bath lift has been replaced since the last inspection. The living room has been redecorated and there is ongoing upkeep of the fabric of the home. Keeping the home clean is facilitated by having a water softening system. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 15 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 Mr & Mrs Wyatt represent an “effective staff team”. The service is provided on both a professional and familial level by providers who between them have the desired competencies and training level. EVIDENCE: The home employs no staff, all care being delivered by Mr & Mrs Wyatt. Accordingly, most of these Standards do not apply to the home. Mrs Wyatt is separately employed as a nurse (RGN) at the local hospital for 30 hours per week, most of that working time being during the service user’s absence from the home. Mrs Wyatt takes primary responsibility for the service user’s personal care, and for record keeping, report writing and medication. Mr Wyatt concentrates on the service user’s activities needs, social integration, transport needs and maintenance of the home. Their competencies have developed over the service user’s lifetime, augmented in Mrs Wyatt’s case by continuous professional development in her nursing career. A recent letter to the Wyatts from the service user’s family indicated their total confidence in the care service provided. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 16 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, 39, 41, 42 & 43 The home revolves around the service user’s routines and needs, backed by record-keeping procedures appropriate to the scale of the service. A number of systems enable the providers to monitor and maintain their high standards of care. Health and safety are actively promoted. EVIDENCE: Quality assurance appropriate to the scale of the home is effectively provided for by the nature of care planning, with purposeful three-monthly reviews; by annual meetings with significant members of the service user’s birth family; and by the inspection report process, to which the Wyatts respond positively. Provision for health and safety, including fire precautions, is appropriate to the domestic scale of the home. The service user has two wheelchairs, one of which is maintained by her day service, the other being monitored by Mr Wyatt. The latter showed correspondence confirming his imminent inclusion in first aid training, as required at previous inspection. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 17 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 3 N/A N/A N/A x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 4 4 4 4 4 4 4 Standard No 11 12 13 14 15 16 17 4 4 4 4 4 3 4 Standard No 31 32 33 34 35 36 Score N/A N/A 3 N/A 3 N/A CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Springhead (1) Score 4 4 N/A x Standard No 37 38 39 40 41 42 43 Score 4 N/A 3 x 3 3 3 D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 18 NO 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 Regulation Requirement No requirements have been set as a result of this inspection. 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 Good Practice Recommendations No recommendations have been set as a result of this inspection. Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 19 Commission for Social Care Inspection Avonbridge House Bath Road Chippenham Wiltshire SN15 2BB 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. Extracts may not be used or reproduced without the express permission of CSCI Springhead (1) D51_D01_S28391_SPRINGHEAD_v176645_240805_Stage4.doc Version 1.40 Page 20 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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