Inspection on 25/07/05 for 11 Buckstone Close

This inspection was carried out on 25th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 but made no statutory requirements on the home.

Other inspections for this house

11 Buckstone Close 01/08/07

11 Buckstone Close 21/09/06

11 Buckstone Close 09/01/06

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 0EU Lead Inspector Sue Kinch Unannounced 25 July 2005, 8.40 th 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. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service 11 Buckstone Close Address Everton, Lymington, Hampshire SO41 0EU 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) 01590 643723 Bell House Homes Ltd Care Home 3 Category(ies) of Physical disability (3) registration, with number Learning disability (3) of places 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1 Service users only may be admitted between the ages of 18 and 60 years Date of last inspection 23/02/05 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. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first statutory, unannounced inspection for the year 20052006.The inspection was carried out between 8.40 and 14.45 although several breaks were made when staff and residents were away from the house. The inspector was able to have conversations with two residents using staff support and sign language. Discussion with two staff and the manager also took place. A sample of records was viewed and some documents were observed. What the service does well: What has improved since the last inspection? What they could do better: A full application for a manager with all the accompanying paperwork had still not been received by CSCI although progress is being made towards this. The home needs a registered manager. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 6 The manager spends most of her working time on shift. Some of this time can be used for management activities when residents are all out of the home but this does not allow adequate opportunities for staff management and needs revising. Work is still needed to ensure that recruitment practices for relief and agency staff are robust and paperwork completed before staff are used at the home. Arrangements need to be made for annual specialist check of the fire system. Staff have received the Bell House Homes induction and some induction training but evidence is needed to demonstrate that the induction and foundation units based on the Learning Disability Award Framework have been fully completed and qualification obtained. 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 H54 S12386 11 Buckstone Close V236910 250705 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 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 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) not assessed. EVIDENCE: 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 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 The support given enables residents to make decisions and develop their service plans to meet their needs taking risks into account and promoting independence. EVIDENCE: In the last inspection report it was required that care plans must include more details of staff guidance. Observation of two files demonstrated that this had been addressed. From discussion with a staff member and observation of interaction between a staff member and residents, the inspector identified areas of care, which should be detailed in the care plan. Where checked this information was available. A staff member confirmed that residents are involved in care planning. Goals have been identified for residents and there is recording to show that these are being worked on. Work has taken place to update risk assessments and this is ongoing. There is written evidence that residents are involved in these where possible. A member of staff agreed with this. One specific risk issue was discussed with a staff member and the manager separately. The daily recording had indicated that staff were monitoring the issue closely and temporary action plans were in place in the daily records prior to the risk assessment being fully revised. The 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 10 inspector advised that where the new plan involved an agreement with a resident and included a restriction, a record should be established. From the discussion the inspector deduced that staff were very aware of the key issues of promoting independence but offering protection where necessary and risk assessing to assist with this process. The member of staff working at the beginning of the inspection was promoting choice and independence in the resident’s morning routines. He showed an understanding of differing needs and wishes and respected this. Communication with the service users was through sign language, finger spelling and gestures, which the member of staff was using effectively. The member of staff gave examples of how service users are involved in a range of household activities including cooking, shopping and menu planning. Three comment cards were received from the residents and all indicated that they would like to be more involved in the decision making in the home. The inspector did not have an opportunity to explore this during the inspection as residents went out after half an hour. The manager was advised to follow this up. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 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 standard(s) 12,13,14,15,16, The structured recreational and developmental activities programmed on an individual basis offer residents interesting and varied activities. EVIDENCE: Residents care plans clearly identify how they are to be supported in a range of activities, which interest them. Daily recording and monitoring of activities demonstrate that a variety of these take place regularly in the local community as well as at clubs or day centres for people with learning disabilities. Two residents use day service services 5 days a week but the manager was aware that one person’s needs were changing. Alternative options were being explored. The other resident have a more flexible timetable that the member of staff spoken to felt was more suitable to meet his needs. Hobbies and interests are encouraged and there was evidence of this in the one bedroom that was seen and in examples discussed with a member of staff. All the service users had been to the local steam rally at the weekend. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 12 Discussion was held about how one resident is assisted to maintain contact with his family. Staff also gave an example of working on friendships and acquaintances with a resident. A positive approach to contact with families and friends was noted. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 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 standard(s) 18,19,20 Support provided to residents enables them to access health care professionals to meet their needs. Individual personal support respects privacy and dignity. Residents benefit from an effective medication system. EVIDENCE: Support with personal care was being given at the beginning of the inspection. This was provided in a gentle and careful manner. The member of staff was fully aware of the individual needs of the residents and was prompting and encouraging aware of individual abilities. Personal care needs were recorded in the care plan seen. Written evidence was available in the records seen demonstrating that medical issues were being followed up. A resident had been admitted to hospital during the evening before the inspection and was being supported by the manager and later, a staff member. Physical and emotional needs are addressed. The manager and staff highlight the need to be able to use finger spelling and Makaton to communicate with two of the residents effectively. This was in use during the inspection. The staff member working demonstrated an understanding of the varying 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 14 communication needs in the home. He had received some finger spelling training and anticipated Makaton training. The staff at the home administer prescribed medication. On this occasion the medication stocks were sampled and checked against the administration sheets. This was accurately completed. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 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 standard(s) not assessed EVIDENCE: 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) not assessed . EVIDENCE: 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35 An increasingly supported and trained staff group work with service users although records should demonstrate that training is taking place. The procedures for staff recruitment are not yet robust enough to adequately safeguard service users. EVIDENCE: In the last inspection report it was required that staff levels were reviewed taking management time into account. A record of this review and a rationale for the decision was also required to be held in the home. At this inspection a record was in place but no change to the staffing level had been made. The manager does not have enough time off shift to be available in the home when other staff are working. This must be addressed. In the last two inspection reports it was required that completed staff records were held in the home. At this inspection some of these were sampled and it was found that there was not enough evidence of checks such as references and details of previous employment for relief staff. Similar findings were made in respect of agency staff. Discussions with the manager were held about the nature of the details needed and the requirements of regulation 19 of the Care Homes Regulations. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 18 Support and training was discussed with a member of staff who confirmed that this is being provided. The inspector was informed that supervision and staff meetings are regular. Progress is discussed every three months and training needs are reviewed. Support and guidance is regularly given about how to work with individual resident’s needs. The Learning Disability Award Framework, which influences induction and foundation training, was discussed with the manager. Staff had attended courses but there was no written evidence that they had completed the workbooks and had their work evaluated or achieved the related qualification. The manager agreed to ensure that the system for this was implemented. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) 37,42 Service users benefit from a committed manager although her registration must be completed. Health safety and welfare is increasingly promoted in the home but some attention to detail is needed. EVIDENCE: In the last inspection report it was required that a manager’s application to register was submitted to the Commission. A full application had not been received by this inspection. Elements of health and safety were checked. No obvious hazards were noted in the home. The manager reported that basins had been fitted with thermostats and there was written evidence of water temperature checks. This had been required in the previous report. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 20 Elements of in house fire checks were sampled and these had been carried out within appropriate timescales. In sufficient records of annual specialist fire checks were found and brought to the manager’s attention. Staff fire training records were observed and discussed with the manager who agreed to ensure that training of relief and agency staff needed to be included in the log. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 x Standard No 31 32 33 34 35 36 Score x x 2 2 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 11 Buckstone Close Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x x 2 x H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 22 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. 2. Standard 33 34 Regulation 18 19 Requirement Staffing levels must be adjusted to allow more non shift time for the manager. Evidence of full recruitment checks for relief and agency staff must be in the home.This is a repeated requirement from the inspection of 23/2/05. Evicence of completion of the induction and foundation training based on LDAF must be held at the home. The Registered Person must ensure that the manger is registered.This was a repeated requirement raised from the inspection of 23/2/05. Specialist fire checks must be made anuually and evidence held in the home. Timescale for action 25/9/05 25/9/05 3. 35 18(c)(i) 25/9/05 4. 37 8 25/9/05 5. 42 23(4) 25/9/05 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. 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 23 Refer to Standard Good Practice Recommendations 11 Buckstone Close H54 S12386 11 Buckstone Close V236910 250705 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Hampshire Area 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. 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