Inspection on 22/12/05 for 17 Flaxfield Road

This inspection was carried out on 22nd December 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 no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

17 Flaxfield Road 02/02/07

17 Flaxfield Road 25/04/05

17 Flaxfield Road 13/12/04

17 Flaxfield Road 11/05/04

17 Flaxfield Road 15/12/03

Similar services:

Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 17 Flaxfield Road Basingstoke Hampshire RG21 8SE Lead Inspector Ms Wendy Thomas Unannounced Inspection 22nd December 2005 15:00 17 Flaxfield Road DS0000011802.V274826.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 17 Flaxfield Road DS0000011802.V274826.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. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service 17 Flaxfield Road Address Basingstoke Hampshire RG21 8SE 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) 01256 28273 www.mencap.org.uk Royal Mencap Society Mr Michael Gordon Butterworth Care Home 5 Category(ies) of Learning disability (5) registration, with number of places 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 25th April 2005 Brief Description of the Service: The home is a semi-detached property set in a cul-de sac-within Basingstoke. It is within easy reach of the town centre and the local college. The home offers all single rooms on the ground and first floor. There is a lounge/diner, kitchen and ample bath and shower facilities. There is a small quiet area at the top of the stairs, which contains a computer for service users to use. The home has kitchen and laundry facilities and garden to the rear. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that took place on Thursday 22 December 2005. The inspector spent time talking individually with three service users and with another in the presence of the home’s manager. She also had discussions with one of the staff and the manager. The care plans and diaries of one service user were examined and others looked at for specific information. The medication policy and recording were also seen. What the service does well: What has improved since the last inspection? What they could do better: Most staff have worked in the home for some time and are familiar with the service users, however for new staff or staff needing to cover in an emergency,the service users’ care plans do not give sufficient detail for staff to be able to support them as they need/would like. There are also insufficient guidelines for supporting service users when their behaviour becomes challenging to others. In such circumstances it is particularly important that all staff respond in a consistent manner. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 6 A medication policy outlining how medication is supplied to the home, stored, administered, recorded and disposed of is needed so that staff are clear what should happen in that particular home. The current one refers to Mencap homes in general. This will help to reduce the opportunity for error and make clear the action to take should such an incident occur. 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. 17 Flaxfield Road DS0000011802.V274826.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 17 Flaxfield Road DS0000011802.V274826.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. The admissions procedure ensures that service users benefit from a phased introduction to the home. EVIDENCE: The home has not had any new admissions, however the manager explained that if a vacancy were to arise Mencap’s admissions procedure would be followed. He said that a referral would be made by social services and an assessment would be provided. He would then meet the prospective service user and carry out an assessment for the home. It would then be decided if the home could meet the person’s needs and whether they would fit in with the other service users. If so, the potential service user would be able to visit the home on several occasions. Ideally this would include a visit for a meal, a whole day visit, an over night stay and a weekend stay. Then, if all parties wished to go ahead, the service agreement/contract would be negotiated and there would be a planned integration into the home. 17 Flaxfield Road DS0000011802.V274826.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): EVIDENCE: 17 Flaxfield Road DS0000011802.V274826.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): 12, 13, 15 and 17. Service users benefit from support to take part in a range of activities both locally and further afield. Service users benefit from support and encouragement from staff to maintain and develop friendships and contact with their relatives. Improving food records would give a fuller picture of the variety of food the service users receive. EVIDENCE: The inspector spoke with three of the service users about the activities they are involved in. Service users, staff and the manager described recent day trips to Hayling Island, the Watercress Line, a steam fair and Finkley Down Farm, visits to the cinema, theatre (old time music hall), and a local pub. One service user said, “I like cinema I do … I like Disney.” Another service user when asked where they went said, “to the pub” and “to work”. The manager explained that the latter referred to a day service the service user attended four mornings a week. Other service users also attended day services and an 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 11 advocacy group on a regular basis. Some were involved in several local social clubs for disabled people, which they attended regularly in the evenings. The diary for one member of the household was examined for the previous fortnight. They did not attend regular day services but had been out almost everyday and had been involved in a variety of activities. Two of the service users spoken with said that they went to church. The home is close to the town centre and the service users can easily access the local facilities. Discussions and diaries demonstrated that this was happening frequently. One service user described their summer holiday, which they had enjoyed. The home does not support service users on holiday, so they need to go to a holiday environment where appropriate support it provided. Service users and the manager mentioned two holiday locations that were used. All of the service users have contact with members of their families. The manager described how, if relatives weren’t able to visit the home, the service users would have support from the home to visit them. Service users described friendships with people within and outside of the home. Both, people who were important to them and people they did not like. There had been a house bar-be-que in the summer that service users had invited their friends to. Another member of staff also said that they encouraged service users to invite fiends back to the house, but that they tended not to. During the inspection a friend of the household visited with their children. Most of the service users and staff spent time with them in the lounge/dining room. One of the service users said that they were helping a member of staff prepare the tea. They were cooking sausages which they let the inspector know were their favourite. The home operates a four-week rolling menu. The inspector saw this. There were a variety of meals, however it was suggested that these could be improved nutritionally with the inclusion of more vegetables. Less than half the meals included vegetables and on one week there was a run of three days without vegetables. Food records were seen. These could be improved by covering more than just the main meal, as the manager said that although vegetables did not feature greatly on the menu, service users did eat a lot of fruit. They are encouraged to have fruit rather than sandwiches for snacks, and they also take one or two pieces when they take a packed lunch to their daytime activities. Following the inspection, the manager reported that he is trying to involve a dietician to advise on the home’s menu. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 12 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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. Improved care plans would enable care to be given to service users in a more consistent manner. Service users benefit from support to access healthcare professionals as needed. The medication system would be more robust and offer greater protection to service users if a procedure giving details of the medication system specific to the home were developed. EVIDENCE: One service user was asked about their personal care needs. They were satisfied with the care that was given. The care plans outlining the support service users needed from staff regarding their personal care needs should contain more detail. For example the format for the care plans asks, “ How able is x to clean his/her own teeth?” The response said that the service user could do this, “with support.” There were no details as to what this support might be. There was also insufficient detail for staff to be able to support service users in a consistent way in relation to behaviour. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 14 Service users meet with their key workers once a month and complete a “monthly key worker/client meeting and report” form. The form included helpful prompts for the meeting. Service users have support to access local healthcare professionals as and when needed. It was explained by the manager that the specialist healthcare team were involved when issues arose and were currently working with two individuals on complex issues. The manager reported that one service user had music therapy. This was also recoded in their diary. The medication administration records were examined. One error was noted and the circumstances discussed. The home follows a general Mencap medication policy. This does not specify the particular details that apply in the home. A policy giving step-by-step guidance as to how medication is requested, stored, administered and disposed of at 17 Flaxfield would clarify what staff were expected to do. It would explain what to do if something was missed or not recorded etc., and hence reduce the risk of errors. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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. The home’s complaints procedure ensures that the views of service users and their representatives are taken seriously. EVIDENCE: The home’s complaints log gave brief notes of complaints dealt with by the home. However, a new format had been introduced requiring more detail including an “outline of the complaint” and the “outcome”. This will give a satisfactory level of information about the complaint and how it was dealt with. The manager reported that since the last inspection he had dealt with two informal complaints. He described these as being grumbles and said that they had been satisfactorily resolved. There had been one formal complaint, and that too had been resolved to the satisfaction of the complainant. A new complaints form had been devised for use with service users that includes symbols and pictures. It also prompts staff towards issues to consider when dealing with the complaint. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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 the following standard(s): 30. The service users benefit from support to maintain a satisfactory level of cleanliness in the home. EVIDENCE: At the previous inspection it was noted that the home, including bathrooms and toilets were clean and free from odours and that a service user spoken with was happy to participate in keeping the home clean. On this occasion the areas of the home seen were also clean and free from odours. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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 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, 35 and 36. Service users benefit from a staff team who are carefully recruited and receive training pertinent to the service users’ needs. EVIDENCE: The manager and the member of staff spoken with were happy with the training that they had had. The manager said that staff can attend courses run by Mencap, and that outside training agencies are also used. The staff team are recognising the changing needs of some service users and attending training relevant to these, such as, dementia and bereavement. It was reported that they hoped to be attending courses on autism, epilepsy and communication shortly. A member of staff stated that in relation to training, “Everything I’ve asked for I’ve been on.” Staff training was being satisfactorily recorded. The manager expressed a commitment to staff development and encouraged them by giving each member of staff an area of particular responsibility. The manager reported that the home meets the target of having at least 50 of the staff trained to a minimum of NVQ 2 in care. The previous inspection report required that staff levels should be reviewed in relation to service users needs. The manager reported that the vacancy, that had given rise to this requirement by creating a high level of bank staff use, 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 18 had now been filled. Bank staff are now only being used to cover, annual leave, sickness and training. Discussions with service users and examination of their care plans and diaries indicated that they were being supported to pursue activities that interested them, and were able to have support in the areas they required. The manager said that the staff rotas were designed around the wishes and requests of service users so that support was available when they required it. One member of staff had been appointed since the last inspection. Their records were inspected, all the expected documentation was present and a satisfactory recruitment procedure had been followed It was said that formal supervision sessions were supposed to be happening monthly, however the records for a member of staff inspected showed that they had had supervision in June and August. It was reported that they had also had supervision in December but that the notes were not yet in the file. The manager confirmed that supervision was not happening as often as it should, but he stated that he dealt with issues as they arose. The National Minimum Standards expect that supervision sessions take place at least six times a year. This was not happening at 17 Flaxfield. The member of staff spoken with, however, said that they felt well supported by the organisation and the manager. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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 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 and 39. The manager’s philosophy ensures that service users’ needs are put foremost in the running of the service. Service users have their views taken into account in the annual quality assurance process. EVIDENCE: The manager confirmed that he has completed the work for his registered manager’s award and that it has been sent away for accreditation. Discussions with the manager demonstrated his value base to be focussed on supporting service users to achieve their goals and to run the service around their needs. The manager explained the annual quality assurance process, which includes service users completing a survey devised by Mencap about, “My home.” Where service users have advocates, they support them to complete these. The home’s manager supports the others. There was some discussion about other personnel who could support service users without advocates to 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 20 complete these, however the manager thought that this was the best way. An annual quality assurance report is made to the home and action plans are then developed in response to points made, and to improve the quality of the home. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 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 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 X 23 3 ENVIRONMENT Standard No Score 24 X 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 3 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 3 13 3 14 X 15 3 16 X 17 2 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 3 2 X 3 X 3 X X X X 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 22 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 YA18 Regulation 15 Requirement Care plans must give sufficient detail to enable staff to support service users in a consistent manner, in particular in relation to personal care and support regarding behaviour. Timescale for action 13/04/06 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 2 Refer to Standard YA17 YA20 Good Practice Recommendations Service users would benefit if the menus included more vegetables. A localised procedure is needed detailing how medication is requested, stored, administered and disposed of at the home. 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 23 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 17 Flaxfield Road DS0000011802.V274826.R01.S.doc Version 5.1 Page 24 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!