Inspection on 21/09/06 for 11 Buckstone Close

This inspection was carried out on 21st September 2006.

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 no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

11 Buckstone Close 01/08/07

11 Buckstone Close 09/01/06

11 Buckstone Close 25/07/05

11 Buckstone Close 23/02/05

11 Buckstone Close 07/09/04

11 Buckstone Close 17/02/04

Similar services:

Flint House

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

The Cotswold Home

Fairways

Treloar College

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

CARE HOME ADULTS 18-65 11 Buckstone Close Everton Lymington Hampshire SO41 0UE Lead Inspector Liz Palmer Unannounced Inspection 21st September 2006 09:30 11 Buckstone Close DS0000012386.V300055.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 11 Buckstone Close DS0000012386.V300055.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. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 11 Buckstone Close Address Everton Lymington Hampshire SO41 0UE 01590 643723 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) Bell House Homes Ltd Sarah Brownbridge Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users only may be admitted between the ages of 18 and 60 years 9th January 2006 Date of last inspection Brief Description of the Service: The Bungalow, 11 Buckstone Close, is a care home providing personal care and accommodation for 3 service users with a learning disability. It is managed by Bell House Homes Limited which has a number of other registered properties in the area. The home is located in the village of Everton, which has a limited range of facilities, but with relatively easy access to the shops and other public amenities in the town of New Milton. The home comprises a detached property with car parking for 2 vehicles to the front of the building and a wellmaintained and accessible garden to the rear. All bedrooms are occupied on a single basis. There are two communal rooms on the ground floor, both easily accessible to service users. The fees range from £566.23 - £2070.06 per week. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection included a visit to the service which took five hours. Other information provided by the home prior to the visit was used including a preinspection questionnaire. During the visit all of the service users were met and two were case tracked and gave their views on the home. Service users were also observed being supported by staff. Two care staff were met and were interviewed. The manager was present and assisted with the visit. Care plans and other paperwork including policies and procedures were sampled. What the service does well: What has improved since the last inspection? The manager has been registered. The requirement made at the last inspection regarding records held to identify agency staff has been met. The requirement made at the last inspection regarding Protection of Vulnerable Adult checks has been met. Improvements to the storing and recording of medication have been made following an internal audit. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 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. 11 Buckstone Close DS0000012386.V300055.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 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. 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. Arrangements are in place for prospective service users’ needs to be assessed to ensure they can be met before offering them a place in the home. EVIDENCE: No new service users have been admitted to the home since the last inspection and there are no vacancies. This standard was assessed and met at the last inspection on 9th and 17th January 2006. No changes have been made to the statement of purpose or admissions procedure. The admissions procedure was discussed with the manager who is fully aware of the need for a full assessment to ensure offers of a place in the home are only made to applicants whose needs can be met in the home. 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans are detailed and regularly reviewed. Service users aspirations and goals are recorded and they are supported to make decisions about their lives. EVIDENCE: Two of the three service users were case tracked and their care plans were sampled. These were found to be detailed and kept under regular review. The home approaches care planning in a person centred way and evidence of service user involvement in drawing up their plans was seen. As well as details of care required the plans included aspirations and goals of service users. Service users spoken to were aware of their care plans and other records kept by the home, such as daily records and incident reports. A key worker system is in place and service users spoken to said they were happy with their key worker. Annual reviews involving families and care managers, where appropriate, take place in the home. Service users are involved in the decision-making in the home and are supported and encouraged to have control over their lives. This was evidenced through observation of service users planning their day and through 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 10 discussions with them. Risk assessments are in place and drawn up on an individual needs basis, for example, accessing the local community, health risk assessment and attending college. There was evidence that risk assessments are regularly reviewed and any changes are noted. However one risk assessment did not reflect what was actually happening with regards to one service user going out and was confusing to the reader. Although staff were aware of the persons needs the manager agreed that the risk assessment needed to be updated. It was also agreed that a risk assessment should be drawn up for one service user who regularly makes allegations. 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from the arrangements for educational, social and community activities. Healthy and varied meals are provided with the involvement of service users. EVIDENCE: Care plans reflect service users individual choices of how they spend their time. Support is offered for community access, attending college, using public transport, visiting relatives and friends and domestic skills. People are supported to be part of their local community, for example, one person goes to church locally every Sunday. One service user who has one to one support said he likes to go out for meals to local pubs in the evening. Evidence of people being supported to pursue their hobbies was seen as was evidence of requests for outings being followed through. Service users said they had enough to do and could get support for the activities they chose. The atmosphere in the home is very much one of promoting independence and offering choice and control to the people who live there. Service users are 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 12 aware of their rights and responsibilities within the home. They say they feel their rights are respected and that staff listen to them and act on the things they say. Weekly house meetings take place where menus are planned for the week ahead. One service user said he helps make a list for shopping and during the inspection two service users were supported by staff to go to the local supermarket for the weekly shop. One service user said they sometimes like to help with cooking and if they change their mind about the planned meal they can choose something else from the freezer. On the day service users were seen helping themselves to drinks and making drinks for others. Evidence was also seen of flexibility and choice being offered around meal times. One person’s daily routines mean that he does not usually eat at the same time as other service users, his rights in this are respected. 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported to maintain their health and receive personal support in a way that meets their individual needs and preferences. New arrangements planned for storing and recording administration of medication will better protect service users. EVIDENCE: Personal care requirements are detailed in individual care plans. Service users said they get the care the need in a way they prefer. Evidence of emotional and physical health needs being considered was seen on individual files. Records of health care appointments and outcomes are kept, including visits to dentists, podiatrists and opticians. Specialist help is sought from relevant professionals if required, for example, occupational therapists and clinical psychiatrists are involved in supporting people in the home. There are support strategies for dealing with anxiety for those assessed as needing this. Others have the support of an advocate if they need it. Policies and procedures for storing and administering medication were sampled. A list of the medications used in the home, what they are for and 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 14 their side effects is kept. Records sampled were accurate as were stocks checked. All staff receive training in medication and the home’s policy for administering reflected what actually happens. As a result of a recent internal audit an internal investigation is being held into a missing controlled drug. A new safe is about to be fitted to store all medication and a double locked safe within that to store any controlled drugs. Improvements have already been implemented to the recording of medication as it is administered and for auditing controlled drugs on a weekly basis. 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are able to complain and have their views listened to and acted on. However, their finances would be better protected if all transactions were clearly recorded. EVIDENCE: Service users have an accessible complaints procedure and those asked said they would know how to complain and who they would talk to about any worries or concerns they had. A record of complaints is kept and there has been one complaint made since the last inspection. This was made by a service user and referred to the area manager and was resolved within two weeks. All staff are trained in adult protection as part of a rolling training programme. As well as a policy for staff there is a service users abuse guide produced in pictorial format. Service users are supported to manage their finances on an individual needs basis. One service user needs a lot of support to manage his money and save for personal items. He has detailed guidelines which he said he was happy with. His records were sampled and all transactions are recorded with receipts where possible. The balance held matched the records and no errors or omissions were found. Another service users records were sampled. This person is supported to shop from catalogues. During the auditing of his records the manager stated she had paid for his first order on her personal debit card. The manager stated she had made the transaction because she did not realise the service user could do 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 16 this with their own bankcard. This was not recorded anywhere and no audit trail for how or when this money was paid back to her could be found. She realised this was a mistake and has since discussed it with her line manager. Arrangements are now in place for the service user to pay for his goods on his own card. A requirement for all transactions of service users money to be transparent has been made. All other transactions sampled were clearly recorded, receipts kept and the balance of cash held was accurate to that recorded. 11 Buckstone Close DS0000012386.V300055.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a clean, safe and homely environment. EVIDENCE: A tour of the home was undertaken. There was adequate communal space and these areas were clean, homely and comfortable. Two service users bedrooms were seen and they were decorated and furnished to reflect individuals’ needs and preferences. A risk assessment of the building has recently been undertaken and health and safety is maintained by staff training, regular cleaning and safety notices. A large well kept garden to the rear of the home is accessible to service users. A new rock garden is in the process of being developed as are plans to grow vegetables. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 18 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Service users are supported by a well trained and competent staff team. However, improvements to staff records would better protect them. EVIDENCE: The two staff on duty during the inspection were seen to be confident and competent at their jobs. Their interaction with service users demonstrated sensitivity and reflected the detailed guidelines set out in care plans. Both said they really liked their jobs and were able to describe in detail the care given to individual service users. They spoke highly of the on going training provided by Allied Care. Mandatory courses such as, first aid, food hygiene, infection control, health and safety and fire training are provided to all staff with a rolling programme for updates and new staff joining the organisation. Other courses undertaken include; Makaton, mental health awareness, medication, autism and adult protection. Training provided addresses individual as well as collective needs. Staff are supported to undertake National Vocational Qualifications (NVQs). Two of the current seven care staff are qualified to level 2, one has gone on the achieve level 3. Three more have started level 2 and the remaining two will start in September 2007. The staff files of two staff were looked at. One of these contained an application form, two written references, a protection of vulnerable adults 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 19 check and evidence of induction and ongoing supervision. One of the files did not have any references on it but all other information was available. Copies of these were later forwarded to the commission along with evidence that the references had been in the home during a Regulation 26 visit on 24/02/06. These records must to be available for inspection. Two requirements regarding recruitment were made at the last inspection, one for results of Protection of Vulnerable Adult (POVA) checks to be known before a staff start working in the home, evidence of this being addressed was seen. The second related to the evidence of identity of agency staff being held in the home. No agency staff are currently used in the home but identification details of staff used in the past was held on file. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a safe and well run home which reflects their individual choices and preferences. EVIDENCE: The manager has been in post for eleven months and was registered in May this year. She has achieved NVQ level 4 and is in the process of completing her registered managers award. She allocates herself management time to complete administrative work as well as working hands on with service users. Staff said they felt well supported and that it was a good home to work in. Service users also said they had confidence in the manager. This was evident during the inspection where service users freely made requests and expected to have their needs met. The only concern noted during the inspection is detailed under standard 23 regarding a bill being paid on behalf of a service user with the manager’s own bankcard. This has been addressed and a requirement made. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 21 An annual quality audit is undertaken by Allied Care. This was carried out recently and recommendations made are being addressed by the home. Monthly regulation 26 visits are undertaken and service users are consulted as part of this process. Service users are regularly consulted at house meetings and the atmosphere in the home reflects the wishes and preferences of the individuals who live there. Health and safety is maintained in the home via staff training and suitable notices and instructions for service users. Risk assessments highlight any health and safety issues are procedures are in place to support service users. For example, a fire evacuation risk assessment was seen for one service user to detail his individual needs in the event of a fire. 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 22 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 2 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 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 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 X X 3 X 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 23 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 YA9 Regulation 13 Requirement The registered person must ensure that all service users have risk assessments that are relevant, clear, up to date and kept under regular review. The registered person must ensure that all financial transactions made on behalf of service users are clearly documented. Timescale for action 21/10/06 2. YA23 16 21/10/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 11 Buckstone Close DS0000012386.V300055.R01.S.doc Version 5.2 Page 25 - 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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