Inspection on 28/03/07 for 2, Saxon Close

This inspection was carried out on 28th March 2007.

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

2, Saxon Close 27/02/09

2, Saxon Close 11/01/06

2, Saxon Close 02/08/05

2, Saxon Close 27/01/05

2, Saxon Close 06/07/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 2, Saxon Close Flitwick Bedfordshire MK45 1UT Lead Inspector Mr Paul Worthy Unannounced Inspection 28th March 2007 10.45 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 2, Saxon Close Address Flitwick Bedfordshire MK45 1UT 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) 01525 720170 www.macintyrecharity.org MacIntyre Care Post vacant Care Home 6 Category(ies) of Learning disability (6) registration, with number of places 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11th January 2006 Brief Description of the Service: 2, Saxon Close, residential care home provides long-term care to six people with learning disabilities. The home was purpose built in 1998. MacIntyre care, which is a voluntary organisation, operates the home. The accommodation consists of five single bedrooms, two bathrooms, and one separate toilet on the first floor. The ground floor has a bedroom with en-suite facilities, one separate toilet, a small quiet room, and a large lounge. An office combined with staff sleeping in room is also situated on the ground floor. There is a conservatory and a large rear garden with two summerhouses and a green house. The home is within walking distance of the town centre and its shops. There is and area for parking, and easy access to buses and trains. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was unannounced and started at 10.45 a.m. It took place over 7 hours. The inspector met most of the people living at the home and saw them during the day interacting with the staff and the manager. One person, told the inspector about life at the home and two people showed him their rooms. He also looked at some records and spoke to two members of staff and the manager. Account was taken of the pre-inspection information that the manager had returned. The inspector would like to thank everyone for their help during the inspection. What the service does well: What has improved since the last inspection? The lounge, hall, stairs and landing had been redecorated. A new tumble dryer and dishwasher had been provided. There had been a difficult period since the last inspection because of staff leaving. This period had been well managed and there was almost a full staff team again that worked well together. The more stable staff team has resulted in those living at the home being happier. There are safer arrangements for managing medication. This has involved installing a new medicine cabinet. There is now more money for food. Service users and those that support them will be asked to say how the home can be improved and this will be included in a report each year that tell everyone the improvements that are planned for the next year at the home. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements for assessing the needs of service users to ensure that they could be met. EVIDENCE: There had been no moves to the home since the last inspection. Good arrangements were seen, however, to be in place for ensuring that there was up to date information about the changing needs of those living at the home. This was being helped by the involvement of the appropriate professionals. The current needs were identified on the service users individual plans. Talking to staff indicated that they were very aware of the current needs of those living at the home and the way these could change. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good service user plans which ensured that the needs of those living at the home would be met in ways that took account of their wishes and encouraged as much independence as possible. EVIDENCE: Each personal file contained a number of sections that constituted the service users individual plan. These were seen to provided comprehensive and up to date planning information including, in the final section, aspirations and goals that the staff were supporting the person to achieve. Following the planning information was information relating to the ongoing monitoring and reviewing of the plans by the key workers (called Link Workers) and the manager with a responsibility for overseeing this process. The link worker and the manager met monthly with the service user to monitor and review the plan. Reports of these meetings were seen. In addition there 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 10 were annual reviews organised by the home but involving, as well as the person and their link worker, the a representative of the placing authority and other significant individuals in the life of the service user. The summaries produced for these meetings looked in particular at the progress in helping the service user achieve his or her identified goals and aspirations and suggested new ones for the next year. The whole process of planning with the service user was structured so as to ensure that a person centred planning approach was adopted. This meant that the link workers and those other people significant in their lives supported service users to take control of their own lives. The best ways of communicating with individual service users were identified in their plans. There were weekly house meetings for service users to involve them in decisions relating to the day-to-day operation of the home. These meetings were minuted. They were also used to provide those living at the home the opportunity to express concerns. Pictures were seen to be being used to help service users to be involved in decision-making. The home had a digital camera. The plans were seen to cross-reference to other relevant documents, including guidance notes for helping the service user and risk assessments, where the latter were in a separate file but allowed staff to support those living at the home to be as independent as possible while remaining safe. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 11, 12, 13, 14, 15, 16, 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living at the home were provided with the support that they needed to be able to lead fulfilling and enjoyable lives in and outside the home. EVIDENCE: Arrangements were seen to be in place, including assessment and planning information, to ensure that those living at the home were able to enjoy a full range of normal activities in and out of the home. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 12 The home provided a group living situation where all the service users were encouraged to participate in helping with the daily household activities with the support of staff. This included one person helping make the meal each evening. All the service users participated in drawing up the menus. The service users plans were seen to contain information relating to the meals they liked or disliked and any dietary considerations. There was an awareness that some of those living at the home might, with appropriate support, be able to develop further independent living skills and the normal practice was for each person to have a day at home each week to participate in domestic activities as part of one-to-one time with a member of staff. All those living at the home attended day centres or were employed. Service users also confirmed that they were attending college courses. Details of activities showed that all the service users were supported and encouraged to access the community and enjoyed a normal range of activities. The records provided evidence of those living at the home being supported to maintain their contacts with their relatives and friends, and to attend a place of worship if they wished. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were good arrangements for ensuring that those living at the home received the personal and medical care that they needed to remain in good health. EVIDENCE: There were sections in the service users plans covering personal care. They gave guidance to staff where prompting was required and where actual help was needed. For all those living at the home good arrangements were seen to be in place to ensure that emergency, ongoing and routine medical needs were addressed. These included good assessment and planning information, arrangements for obtaining emergency care and assessments, and for ensuring routine and other appointments were kept. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 14 Appropriate arrangements for managing medication were seen to be in place. There had been a recent move to the multiple dosage system, which staff noted had made it easier to manage and audit the medication. The service users plans contained good medicine profiles that made clear why medication was being taken and other details such as possible side effects. There was an appropriate medicine cabinet, which had recently been provided to allow the blister packs of medication to be held securely. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were effective arrangements for identifying and addressing the concerns that those living at the home might have, so that they would feel in control and safe. EVIDENCE: The service users plans were seen to contain a section relating to the problems each person had in communicating. This included information about the way the person might try to communicate that they were concerned or upset and the action that should be taken if this occurred. Examples of concerns dealt with in the complaints book and also matters picked up during the weekly meeting with service users were seen. An important factor in identifying concerns was the knowledge the staff and manager had of each person living at the home. The arrangements for ensuring that concerns on the part of those living at the home would be acted on were seen to provide the basis for the ongoing vigilance to ensure that they were satisfied with their support and were safe. Arrangements were seen to be in place to ensure that staff had training relating to the protection of vulnerable adults. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The accommodation was well maintained and furnished so that it provided those living there with a homely, comfortable and safe environment. EVIDENCE: The public areas of the accommodation were seen to have a homely and comfortable feel and to be well maintained. The home was observed to be being kept clean and fresh with the help of the service users. Since the last inspection the lounge had been redecorated and new flooring to replace the present carpet was planned. One service user has en suite facilities with a bath to help their independence. An assessment has resulted in a request for the bath to be replaced by a walk in shower. The owner of the room confirmed this and that they were looking forward to having the shower. Two of the 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 17 service users showed the inspector their rooms, which were seen to be personalised to reflect their interests and their choices. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Sufficient staff were appropriately trained and organised to ensure that all the needs of those living at the home would be met. EVIDENCE: The expected staffing levels were seen to be being maintained on a daily basis. There had been a difficult period over the last year with the manager and a number of staff leaving. From what the present manager and staff said there had been a period when those living at the home were clearly upset because of the number of new faces but this had been managed well and the arrangements for using bank and agency staff who were known to those living at the home had ensured the continuity of care. At the time of the inspection almost all the vacancies had been filled. The manager and staff confirmed that the Learning Disability Award Frameworks (LDAF) induction and foundation training was in place and there 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 19 was an ongoing programme of NVQ training. The manager noted that MacIntyre was in the process of preparing for the new Skills for Care LDAF programme. Staff confirmed that there was a robust training programme and ongoing updating. The managers matrix for keeping track of the training needs of the staff was seen. Speaking to staff and observing them interacting with those living at the home showed that they had a good knowledge of the service users and their need for support and encouragement if they were to live as independently and fully as possible. In particular they had a good knowledge of the specialist needs of the service users and the care they needed. The staff confirmed that they were well supported and there were regular supervision sessions and team meetings. The information relating to the recruitment of new staff was not kept at the home so could not be seen. The manager went over the procedures followed during a recent recruitment. This demonstrated that the correct procedures were followed to ensure the safety of the service users. They included the very good practice of involving the service users in the recruitment process. At the time of the inspection the person had not yet started work, as a piece of information required by the precautionary procedures had not yet been received. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Those living at the home benefited from it being well managed so that they could live as independently and fully as possible while remaining safe. EVIDENCE: The registered manager had left in October 2006. A part time acting manager, who was the registered manager at another home, was then in post until an appointment was made at the end of November 2006. This newly appointed manager did not effectively take up the post and so the present acting manager was brought in to work four days a week at the home while using the fifth day to retain an overview of the home for which she was the registered manager. The post is to be again advertised. Staff confirmed that the present 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 21 acting manager was supportive and accessible. She was seen to be providing positive leadership and taking forward MacIntyres programme of continuous improvement. The ethos of the home was friendly and relaxed. The manager commented on what a good staff team there was. Observing the running of the home provided evidence of good systems, including administrative ones, being in place to ensure that the needs of the service users were met. Very good quality assurance arrangements were seen to be in place for monitoring and reviewing the services provided. These included the required monthly visits on behalf of the provider (regulation 26 visits). There was ongoing monitoring of aspects of the home, particularly relating to health and safety matters and these were checked on through the regulation 26 visits. The manager provided copies of the new questionnaires that she had drawn up so as to obtain feedback about the quality of the service from those involved with service users. This was to complement the feedback staff obtained from service users. This information will be used in drawing up the next development plan for 2007 – 2008. The one drawn up for 2006 – 2007 was seen. It tended to emphasise the need to continue to do things already being done or to improve them without specifying what needed improving. An exception to this was the aim of involving service users in the recruitment process, although this did not say how it was to be achieved. As noted in the staffing section above this had been achieved using appropriate procedures. The pre-inspection feedback from the manager confirmed that regular checks relating to health and safety, both by staff and external specialists were being carried out as did the regulation 26 reports on behalf of the provider that were seen. There was a delegated staff member responsible for health and safety matters. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 x LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 3 3 x x 3 x 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 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 Refer to Standard YA39 Good Practice Recommendations The annual development plan should make it clear what the intended improvement to the service will be and how they will be achieved. It should also make clear how the need to make the improvement was identified and make clear the hoped for date (or if a complex project dates) for completing the task. It should be clear if there are cost implications and how it is proposed they should be met. 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 2, Saxon Close DS0000014964.V331115.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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