Inspection on 11/10/05 for 1a White Ladies Close

This inspection was carried out on 11th October 2005.

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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

1a White Ladies Close 18/01/07

1a White Ladies Close 11/01/06

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

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

CARE HOME ADULTS 18-65 White Ladies Close, 1a 1a White Ladies Close Little London Worcester Worcestershire WR1 1PZ Lead Inspector R McGorman Unannounced Inspection 11th October 2005 10:00 White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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 White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service White Ladies Close, 1a Address 1a White Ladies Close Little London Worcester Worcestershire WR1 1PZ 01905 27271 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) MacIntyre Care David Joseph Bunn Care Home 5 Category(ies) of Learning disability (5) registration, with number of places White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The current Statement of Purpose and Service User Guide for the home will be reviewed and produced in the MacIntyre format by 30th June 2005. Staffing levels will be maintained in accordance with the correct time specified by Worcestershire County Council (see `Staffing Schedule`) and reviewed in consultation with the CSCI by 30th June 2005 to reflect the revised Statement of Purpose. Any improvements required by other regulatory agencies will be carried out within the time-scales agreed with the CSCI and by 30th September 2005 at the latest. 8th February 2005 3. Date of last inspection Brief Description of the Service: 1a, White Ladies Close is registered to provide residential care for up to 5 adults who have mild to moderate learning disabilities. The premises is a large, detached, purpose built house, situated in a residential area, close to the centre of the city of Worcester, and with easy access to various amenities and facilities. The Registered Provider is MacIntyre Care, who has recently taken over this responsibility from the Royal Mencap Society. The property is leased from the Sanctuary Housing Association. The stated purpose of the organisation is, ‘to be recommended and respected as the best provider of services for people with learning disabilities throughout the United Kingdom.’ The main aim of the home is to encourage service users to achieve optimal personal independence in their lives, both within and outside the home, with supervision, support and assistance from staff where needed. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The purpose of this routine, unannounced inspection was to follow up previous recommendations, and to monitor the care provision at the home. The inspection took approximately 3 hours, and time was spent talking with the 2 members of staff on duty, and 5 service users living at the home. Everyone indicated they were happy to be living and working at 1a, White Ladies Close. In addition the manager, David Bunn, although on leave, came in to assist with the inspection, and the deputy manager briefly joined the group, on her return from a meeting. The assistance and co-operation given throughout the inspection was very much appreciated. A tour of the building was also undertaken, and some service users kindly showed the inspector their bedrooms. The care records were briefly seen, and also the records kept in respect of the maintenance of equipment and safe working practices were checked. What the service does well: What has improved since the last inspection? White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 6 Health Action Plans have been developed for each service user, which are detailed and informative, and ensure a full understanding of their healthcare needs. Documentation relating to service users has been reviewed, and the information collated into a more holistic and person centred format. The guidelines on protection, produced by Worcestershire County Council have been implemented. New furniture has been provided in the dining area, and a service users bedroom, which has also been decorated. 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. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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 White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 1,2 & 4 Documentation is in place to provide information to service users or their representative, but this needs further development to ensure that relevant details enable an appropriate decision about their future care needs. The admissions procedure is followed in detail, and all proposed admissions to the home are planned very thoroughly, over several weeks, to ensure an appropriate decision is made, both by staff at the home and also the service user. EVIDENCE: A Statement of Purpose and the Service Users Guide have been produced by MacIntyre Care, and provide much of the information identified by this standard. Further amendments are necessary to ensure clarity, and these will be discussed with the Regional Manager, in due course. The complaints procedure, which is included in these documents, also needs to be reviewed. The admission procedure was discussed with the manager, and includes extensive assessment by staff from the home, which would take the necessary length of time needed for an appropriate decision to be made by the relevant parties. A gradual introduction is made to the home following the initial referral, and a place is only offered if it seems likely that a suitable service can be provided for the prospective service user. Admission is agreed on a trial basis initially. There have been no new admissions to the home for almost two years. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 6,8 & 9 The service users plan of care is based on the initial assessment, which clearly identifies their assessed needs, and how these will be met. Service users living at the home are supported in making choices in all areas of their lives. Risk management strategies enable a responsible approach to the risks associated with the various activities of daily living. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 10 EVIDENCE: An individual plan of care is produced for each service user, based on the initial assessment undertaken during the admission process. These care plans are very comprehensive, and the person centred approach has been introduced. Reviews are undertaken regularly with service users, and the involvement of family is encouraged. A request had been made previously, for a formal review by the placing authority, for two service users without a Community Care Assessment, but as a positive response was not received, staff have undertaken their own assessment. Detailed risk assessments are completed, in relation to the premises, to the activities undertaken, and any restrictions that may be imposed, and also in respect of every aspect of the life of each service user. The needs and individual preferences of each service user are identified, and their participation in the daily life of the home, is constantly encouraged. ‘This is their home’, a member of staff said, and ‘we are here to support’. Regular time is spent each week by service users, with their key worker, and a record is maintained, of the issues discussed. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 11,12,13,14 & 16 The opportunities made available to service users, and their regular involvement with family and friends, enables them to live as fulfilling a life as possible. Service users are involved in all the arrangements at the home, and everyone is involved in planning their daily activities, both within and outside the home, which ensures a good quality of life for each individual. EVIDENCE: White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 12 Service users are encouraged to follow an ‘ordinary’ life style as far as possible, by using the same facilities as other members of the community, and being involved in a range of leisure activities, of which a detailed record is maintained. Several service users have enrolled at college and participate in various courses that include cookery, computer studies, art, life skills and gardening. In addition, some service users attend day centres, the Social Education Centre, and Top Barn Farm. One service user works at a local hostelry Activities in which service users are involved are many and varied, and these may be in-house or in the community. They include, household tasks, assisting with preparing meals, listening to music, gardening, going for a walk, bowling, swimming, going to the pub, and playing bingo. A regular event is to go into town on Saturday mornings to have breakfast, prior to shopping and leisure activities. Arrangements for holidays are made, and have included Weymouth and Blackpool recently, and some service users have holidays, or spend weekends with their family. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 18,19,20 & 21 Support is provided to each service user, and encouragement given to promote independence as far as possible, in meeting the personal care needs of each individual. Advice and guidance is available from the primary healthcare teams, and associated specialists, to ensure that the health needs of service users are fully understood, and that appropriate responses are made. Arrangements for the safe administration of medication are in place at the home. EVIDENCE: White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 14 The personal and care needs of service users are well documented, and there is evidence to show how staff understand and respond to them in an appropriate way. Personal care is provided in privacy. The healthcare of service users is closely monitored, and additional specialist support and advice is sought from the primary health care team, and other health professionals, when necessary. Evidence was discussed of the support being currently provided by staff at the home, in respect of a service user whose health has been of concern during recent months. A Health Action Plan, which forms part of the national development framework for people with a learning disability, has been developed for each service user living at the home. Medication arrangements at the home are satisfactory. A monitored dosage system is in use, and regular checks by the pharmacist are undertaken. The Medication Administration Records are being completed appropriately. The issues relating to the ageing, illness and possible death of a service user, were discussed with the manager, and the need for training to be provided for staff, to increase their awareness, is to be considered. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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 & 23 A satisfactory complaints procedure is followed at the home, and service users are encouraged and enabled to express their views and opinions. The manager demonstrated an awareness of the issues relating to abuse, which should ensure the protection of service users, although the need for further training for some staff was identified. EVIDENCE: A complaints procedure has been produced and is included in the information provided to service users. The document has been discussed with individual service users and is produced in a format that is understandable to them. They are provided with coloured cards to enable them to direct their complaint to the appropriate person. A record of complaints is maintained, although none have been received at the home recently. The management of the home is able to demonstrate a clear understanding of the issues relating to abuse. The need for training for all staff on the Protection of Vulnerable Adults (POVA) was discussed. A copy of the Guidelines produced by Worcestershire County Council, for responding to suspicion of abuse, have been obtained White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 24,25,27,28 & 30 The premises are suitable for their purpose. They are nicely furnished and clean, and ensure as far as possible that the safety and wellbeing of service users is promoted. The location of the house is convenient to local services and facilities, and the layout provides adequate communal space for the needs of service users. The standard of the accommodation is satisfactory, and provides service users with a comfortable and homely place to live. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 17 EVIDENCE: The premises at 1a, White Ladies Close, is a purpose built, detached house with accommodation on two floors, which is maintained to a satisfactory standard, and is suitable for its purpose. The gardens to the rear of the property are delightful, and consist of a patio, which can be accessed through French windows from the kitchen, and a lawned area, for the use of service users. There is also a lovely selection of flower pots and tubs, containing a colourful display of summer flowers. There are five single occupancy bedrooms for service users, on the first floor, which comply with the space requirements. The bedrooms seen are nicely furnished and have been personalised by their occupants. There is also a bathroom and a shower room on the first floor, and sleeping accommodation for staff. The communal areas of the home are nicely decorated and comfortably furnished. There is a pleasant, good sized lounge, and a smaller, quiet sitting/music room, which also has computer facilities for the use of service users. There is large kitchen/dining room, with a refectory style table. The various shared areas provide very flexible accommodation for residents. The requirements following the last visit of the Environmental Health officer, in April, have since been met. The home is clean and free from offensive odours. Procedures are in place in regard to the control of infection, and training is given to staff on health and safety matters. The Fire Safety Officer inspected the home in April 2005 and the recommendations made following the visit have been addressed. The Fire Log Book was seen, and has been completed to a satisfactory standard. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 33,35 & 36 There is an experienced staff team at the home, with skills and experience relative to the work they are doing, which ensures that the needs of service users living at the home are effectively met. The training programme available to staff provides then with the competencies necessary for them to be effective in their work. Supervision procedures ensure that all staff are given appropriate support. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 19 EVIDENCE: The manager confirmed that appropriate staffing levels are maintained to provide for the identified needs of service users. There is minimal use of relief staff, and one is soon to become a member of the team, while one support worker is transferring to another home in the organisation. A training programme is in place at the home, and an individual profile is produced for each member of staff. Recent training has included, basic first aid, moving and handling, medication, person centred planning and challenging behaviour. Consideration is to be given to future training to include dementia awareness, death and bereavement, and the Full First Aid at Work course. Supervision sessions are organised on a six weekly basis, and staff confirmed they are well supported in their work. Comments from staff are very positive about their experiences of working at the home, and also of being employed by MacIntyre Care, which will inevitably be of benefit to service users. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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): 37,38,41 & 42 The management arrangements at 1a, White Ladies Close are satisfactory, and staff and service users benefit from the positive leadership, and the person centred approach to the care they receive. The health, safety and welfare of service users is promoted and protected in respect of all safe working practices. The support provided to staff by the area manager, ensures the promotion of the aims and objectives of the home. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 21 EVIDENCE: The management structure for 1a, White Ladies Close, includes a Service Manager, who is now located in Worcestershire, and a Regional Director and a Managing Director who work at Head Office in Milton Keynes. The Registered Manager has extensive experience in working with this client group, and has achieved the Registered Managers Award. He also has the NVQ Assessors Award. There is evidence that the manager has an organised approach, with a clear sense of direction, and strong leadership skills. The records were not checked in detail during the inspection, although those seen had been completed to a satisfactory standard. The Fire Log indicated that weekly checks of the fire alarm system, and practice evacuations are undertaken. Regular maintenance and servicing of equipment had been done, and temperature checks undertaken. A satisfactory health and safety policy and procedure is in place, and the care manager has a working knowledge of the relevant legislation. Risk assessments in respect of all safe working practices have been completed. White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 3 X 3 X Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 X 3 4 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 3 X 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 White Ladies Close, 1a Score 3 3 3 2 Standard No 37 38 39 40 41 42 43 Score 3 3 X X 3 3 X DS0000064298.V252154.R01.S.doc Version 5.0 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 3 4 Refer to Standard YA1 YA21 YA35 YA43 Good Practice Recommendations The statement of purpose and the service users guide should more accurately reflect the services and facilities available Training should be provided for all staff at the home on death and bereavement Consideration should be given to providing training on dementia to increase the awareness of staff The full First Aid at Work course should be undertaken by senior staff at the home White Ladies Close, 1a DS0000064298.V252154.R01.S.doc Version 5.0 Page 24 Commission for Social Care Inspection Worcester Local Office Commission for Social Care Inspection The Coach House John Comyn Drive Perdiswell Park, Droitwich Road Worcester WR3 7NW 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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