Inspection on 09/01/06 for 11 Buckstone Close

This inspection was carried out on 9th January 2006.

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. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 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 21/09/06

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 Ms Sue Kinch Unannounced Inspection 9 & 17 January 2006 09:30 th th 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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.V273196.R01.S.doc Version 5.1 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.V273196.R01.S.doc Version 5.1 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 To Be Confirmed Care Home 3 Category(ies) of Learning disability (3), Physical disability (3) registration, with number of places 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Service users only may be admitted between the ages of 18 and 60 years 25th July 2005 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. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the second unannounced inspection in the year 2005-2006. The inspection involved talking with two staff two residents and the manager and took 6 hours over two days including the 9th and 17th of January 2006. Some records were viewed. Two bedrooms and shared areas of the home were observed with some of the residents. Findings in this report need to be considered with those of the previous report that addressed the other key standards. The term resident has been used throughout the report based on advice from the manager and a clear preference of one of the residents. What the service does well: What has improved since the last inspection? What they could do better: Work is still needed to ensure that recruitment practices for permanent staff are robust and paperwork completed before staff are used at the home. This includes ensuring that results of POVA checks are known. Identification and 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 6 some specific information should also be held about each agency staff working in the home. The home needs a registered manager. The organisation needs to be prompt in informing the commission of developments and changes, and to ensure that an application is made within a reasonable timescale. The home needs a clear and equitable rationale for charging residents for transport. Residents need access to a complaints procedure, which is clear. 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.V273196.R01.S.doc Version 5.1 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.V273196.R01.S.doc Version 5.1 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 An effective system is in place to ensure that prospective service user’s needs are assessed before admission to the home. EVIDENCE: Since the last inspection the home one resident has left and one has been admitted. Files viewed contained a copy of the care management assessment and supporting documentation obtained before the admission. It also contained an initial assessment completed by the manager using Allied Care forms. Risk assessments and care plans were being developed including specific approaches that could be used. An agency worker was able to be specific about support needed and was seen to be responding to particular issues as advised in the records. Visits including a two-night stay had taken place before the admission to assess the ability of the home to respond to needs and for the new resident to consider the home. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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): Not Assessed The key standards were assessed at the last inspection of 25/07/05. EVIDENCE: 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 the following standard(s): 17 The manager employs a flexible approach to food provision in the home. This assists service users to make choices and decisions on a daily basis. EVIDENCE: Service users are involved in decisions about food at the home. They are involved in menu planning and shopping and preparation if they wish. Two service users asked said that they liked the food. One person preferred hot food and staff confirmed that this was being provided. Another said that favourite foods are included in the menu and the menu does not have to be kept to. Service users can eat meals at varied times if they wish and snacks are available. Food was also planned for a birthday party on the evening of the first day of the inspection. Healthy eating is promoted but also taking service users wishes into account. A member of staff agreed with this. Records of food provided are kept but are not always completed in adequate detail and improvements to this are needed so that intake is monitored sufficiently. The manager spoke of plans to involve a dietician for one person. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 11 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): Not assessed. The key standards were assessed at the last inspection of 25/07/05. EVIDENCE: 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 12 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, 23 Systems are in the home to provide protection to residents, but more work is needed to ensure that the systems in place offer them a clearer organisation of personal monies. An easily accessible complaints procedure could make it easier for service users to raise issues. EVIDENCE: The manager seeks to provide an environment in which residents are listened to and needs acted on. There is a weekly meeting in which they are asked if they have any problems. Two residents confirmed that staff help with their problems. No complaints were raised during the inspection and one resident was able to say who they would complain to. A complaints procedure was not available in an easily accessible format and this was advised. The manager reported that no complaints had been made about the service to residents at the home since the last inspection. The manager has Allied Care policies in the home, which provide guidance to staff about action to take in the event of an allegation of abuse. Staff are provided with training and evidence was seen to demonstrate that the manager and one staff member had received training in June 2005. Evidence is also needed to show that all agency or relief staff have received such training. The manager and staff do work with people who can present challenges. One set of records was observed and information was available about the challenges presented and the de-escalation techniques needed to be used. The 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 13 records noted that there was no assessed need for a planned physical intervention and this was in accordance with the manager’s comments. During the inspection the manager and the agency staff member working dealt with challenges sensitively. The manager and staff are involved in the management of service users money. Money is held for service users. Records are made for each person in relation to the money held at the home. However the set of records seen included a note that savings were held at another registered care home for the person. There were no details of how much so the resident would not be able to check. The manager thought that these records were held at the other home. The service users Disability Living Allowance is received centrally and is not held at the home. The manager was not clear as to how mileage payments were made. Clear details of the service users income and expenditure are required at the home as is a clear charging policy for transport. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 the following standard(s): 24, 30 Residents benefit from regular improvements to the environment which is clean and comfortable. EVIDENCE: The shared areas of the home and two bedrooms were viewed. These were adequately clean and decorated with no unpleasant odours. Since the last inspection the kitchen and the bathroom had been refurbished and provided bright and attractive places to use. The home shares a maintenance worker with the other Bell House Homes and maintenance is attended to regularly. At the time of the inspection some glass panels were being replaced in doors to the dining room and the lounge. The laundry area was clean and included a washing machine and tumble dryer. A guide was on the wall advising staff to wash clothes at 40 degrees. Infection control procedures are available. A member of staff spoken to was not aware of the need to wash foul laundry at 65 degrees for at least 10 minutes. Such laundry does not occur often in the home but the manager was advised to ensure that staff were aware. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 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): 32,33,34,35 The procedures for staff recruitment are not yet robust enough to adequately safeguard residents given their specific care needs. EVIDENCE: Over December 2005 and part of January 2006 the service users received care from a number of agency staff due to two care staff taking annual leave. The manager reported that this was an unusual situation. The consequence had been that although some agency staff were working regularly at the home, at times agency staff had arrived for their first shift and then had slept in with responsibility for the home. The manager reported to have tried to obtain staff known to the service users. However during this time the required staff levels had been maintained and at times the manager had also provided direct care. At the time of the inspection, however the percentage of agency staff used was reducing as care staff returned to work and two new staff had been recruited. It is advised that plans are considered to avoid repeating this situation in the future. The staffing levels at the home had increased since the last inspection to provide two staff for more shifts. However the manager reported that the staffing levels were to be reviewed in order to ensure that all the service user’s needs are met. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 16 As found at the previous two inspections attention is needed to ensure that adequate staff records are in place. On the first day of the inspection there were no records or identification for two agency staff. The manager reported to have addressed this on the second day of the visit. At this time two new staff had been employed. Although records were held for these staff there was no evidence that ‘POVA First’ checks had been completed before employment. In addition the manager was unsure as to whether the CRB checks had been applied for. The manager was referred to the commission’s website and the CRB website for information. An immediate requirement was made to ensure that the results of ‘POVA First’ checks are received before staff start their employment. The manager was also reminded that the commission should be informed when a member of staff starts work before a CRB check is completed. The information given should also confirm the appropriate safeguards that have been taken. Induction was discussed. The home has an induction system that the two established members of staff had followed. Induction for agency staff was discussed. The manager said that a checklist usually provided by the agency had not been completed. It was advised that the home planned it’s own induction for these staff. After the last inspection a requirement was made to complete LDAF induction. This has been changed to a recommendation. Care staff have not yet been assessed to NVQ level 2 or equivalent. The manager reported that this was planned for the two established members of staff. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 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): Residents would benefit from a clear management plan for the home. Risks to residents are reduced in the home by attention given to health and safety. EVIDENCE: It was a requirement in the last inspection report that the manager’s hours were adjusted to allow her more non-shift time. Discussion with her and observation of the rotas showed that this requirement had been met. It was a requirement in the past report that the manager was registered. Although an application form was submitted, it was subsequently withdrawn. The manager has resigned with effect from early February 2006. At the time of the inspection the commission had not been informed of proposals for the management of the home or likely timescales for the recruitment of a manager. At the last inspection it was required that specialist fire checks must be made annually and evidence held in the home. Records were observed and these checks had been made within the last year. Other records were sampled and 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 Page 18 showed that gas safety checks are made routinely and recorded. The two established staff have received health and safety training and it is planned for the two new staff members. Some basic guidance is covered in the induction of staff. As advised in the last inspection report, the training of agency staff in fire evacuation needs to be documented. 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 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 2 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 2 33 3 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X X 2 X X X X 3 X 11 Buckstone Close DS0000012386.V273196.R01.S.doc Version 5.1 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 YA34 Regulation 19 Requirement The registered person must ensure that staff members only commence employment when results of a completed POVA check are known. The registered person must ensure that adequate details and identification are held at the home for agency staff. This is an amended requirement from the inspection of 23/2/05 and 25/7/05. The registered person must ensure that a rationale for charging residents for transport must be developed and implemented. Timescale for action 17/01/06 2. YA34 19 28/02/06 3 YA23 20(1ab) 17/03/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard 22 Good Practice Recommendations It is advised that an accessible complaints procedure is easily available for the service users. DS0000012386.V273196.R01.S.doc Version 5.1 Page 21 11 Buckstone Close 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.V273196.R01.S.doc Version 5.1 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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