Inspection on 24/08/06 for 201a Berrow Road

This inspection was carried out on 24th August 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 no outstanding requirements from the previous inspection report, but made 6 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

201a Berrow Road 27/01/09

201a Berrow Road 01/08/08

201a Berrow Road 03/07/07

201a Berrow Road 24/01/06

201a Berrow Road 23/08/05

201a Berrow Road 30/03/05

201a Berrow Road 05/08/04

201a Berrow Road 02/03/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 201a Berrow Road Burnham-on-sea Somerset TA8 2JF Lead Inspector David Kidner Key Unannounced Inspection 24th August 2006 09:30 201a Berrow Road DS0000016279.V303457.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 201a Berrow Road DS0000016279.V303457.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. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 201a Berrow Road Address Burnham-on-sea Somerset TA8 2JF 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) 01278 786358 MRS VERONICA MARGARET HAWKINS MRS VERONICA MARGARET HAWKINS Care Home 3 Category(ies) of Learning disability (3) registration, with number of places 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 24th January 2006 Brief Description of the Service: 201a Berrow Road is registered to provide personal care for up to 3 people with learning difficulties. Mr and Mrs Hawkins own the home and the Registered Manager is Mrs V Hawkins. Both owners live at the home and provide all care and support. The home is very spacious and is set in attractive gardens. It is within easy reach of Burnham town centre and the sea front. All bedrooms are located on the first floor and are of single occupancy. The home shares a family type bathroom with a bath and overhead shower. There is a large lounge, a separate small lounge area and a large conservatory that leads onto a large rear garden that has a summerhouse. The home has a domestic style kitchen and laundry area. There are currently two service users who live permanently at the home. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. One Inspector conducted this unannounced key inspection over one day (6hrs). The Inspector met with both service users in private as well as in communal areas. Mr Mrs Hawkins was present throughout the inspection and was very welcoming and open. The Inspector viewed records in relation to care plans, risk assessments, health and safety, viewed most areas of the home and viewed records in relation to the management of medicines. The Inspector would like to thank the service users for their involvement and contribution in the inspection process. As part of the inspection process the Inspector sent service user surveys to both service users and discussed these at the inspection. Comment cards were sent to relatives, care managers and the GP. The overall comments received were complimentary of the services provided at the home. At the time of the inspection the service users stated that they liked living at the home and that they liked Mr Mrs Hawkins. As a result of this inspection the home has seven requirements and four recommendations. What the service does well: 201a Berrow Road provides a comfortable home for people who wish to live in a family style environment. It is very well maintained and appears to be very homely. Bedrooms reflect individual needs and preferences. Service users are free to choose when they get up, when they go to bed and how they spend their day. Both service users are able to undertake some activities outside the home independent of Mr Mrs Hawkins. Mr Mrs Hawkins are very pro active in enabling service users to maintain contact with family members. In addition to visits to family records show that service users go out almost daily with Mr Mrs Hawkins and often go for meals outside the home. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. 201a Berrow Road DS0000016279.V303457.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 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 15 The outcome group is Adequate The Statement of Purpose and Service User Guide are in need of updating. EVIDENCE: The Inspector discussed the Statement of Purpose and Service User Guide with Mrs Hawkins and it was agreed that both documents needed some minor updating. The Inspector commented that both documents need to remain user friendly and accessible to both the service users. The Local Authority assists service users living at the home with their fees. Both have financial agreements with the relevant Social Services department. Items such as personal toiletries and hairdressing are not included in the fee. Fees charged are dependant on the assessed needs of the individual. There have not been any new admissions to the home for approximately four years. Therefore, the majority of standards in this section have not been assessed including core Standard 2. 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 679 The outcome group is Poor Care plans do not reflect the current needs of the service users. The care plans do not include limitations and restrictions where required. Service users are offered choices in daily life. The home does not conduct risk assessments to address matters of concern and to promote independence where needed. EVIDENCE: The Inspector viewed both care plans. Mr Mrs Hawkins are the main carers and appear to be very aware of both service users individual needs. The care plans contained brief information as to the likes and dislikes of the service users and there was detailed discussion with Mr Mrs Hawkins in relation to the care plans being more specific and containing more detailed information to identify the areas of need and the support required. However, one care plan did not contain written documentation of the current needs of one service user. This was discussed with Mrs Hawkins at the time of the inspection and must be addressed. It was noted that there are some restrictions are imposed as 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 10 needed. However, the care plans did not reflect this and this must be addressed. Both service users are able to express their needs and currently do not require extra support with their communication needs. There is not a need at present to access Advocacy services. Mr Mrs Hawkins stated that both service users are offered choices in all aspects of daily living. Both service users confirmed this with the Inspector. There is no other staff employed at the home. Service users are not able to manage their personal finances. The Inspector had detailed discussions with Mr Mrs Hawkins in relation to risk assessments. Mrs Hawkins must ensure that detailed risk assessments are conducted that addresses any restrictions imposed on service users. 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 11 12 13 14 15 16 17 The outcome group is Good. Service users access a variety of local leisure and recreational facilities. It appears that the home has very good relationships with the relatives of both service users. Service users appear to treat the home as their home and are encouraged to participate in the running of the home, but mainly choose not to. Meals are provided in the style of a family type environment based on known likes and dislikes. EVIDENCE: Service users are encouraged to participate in household tasks, however it is considered that Mr Mrs Hawkins should encourage further involvement in order to promote independence and develop self-help skills. This was a recommendation at the last inspection and remains. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 12 One service user attends a work placement two days per week and support is provided by Social Services to this. The service user commented that they like the work placement. The other service user also has a work placement one day per week at a farm. Wherever possible both service users access a variety of local leisure and community-based facilities. This was evident at the time of the inspection when one service user went to the local shops. Another service user often goes on walks unsupported. This is a very positive outcome. The home maintains records of all activities and local facilities that service users access on a daily basis. The home operates very much in a family style and outings are arranged in line with this, the daily records viewed demonstrated this. Both service users also have TV’s in their rooms and one service user also has a PS2, video, music centre and DVD. Both service users are free to choose how they spend their leisure time. One service user was relaxing in the summerhouse at the time of the inspection. The home assists both service users to maintain regular contact with their relatives. It appears that there are very good relationships maintained between the home and relatives. The Inspector noted that both service users have unrestricted access to their private rooms and communal areas. Both service users appeared very relaxed and ‘at home’. Both service users choose not to assist with household tasks and the owners accept this. However, one service user stated that they do basic chores around the home. Both service users stated that they like Mr Mrs Hawkins. Service users stated that they are happy with the food in the home. In line with the nature of the service provided there are no set menus and food is cooked on the day in accordance with known likes and dislikes. If the service user does not like the suggested meal option other choices will be offered. Service users have access to the kitchen and are able to make drinks and snacks at any time. The home does not record the meals that are provided, as good practice the Inspector recommended that the home should record the individual meals eaten by the service users in their personal daily diaries. 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18 19 20 The outcome group is Adequate. Service users have access to a variety of health care professionals. The home needs to improve on the management of medicines. EVIDENCE: Mr Mrs Hawkins confirmed that there are no times for getting up and going to bed, mealtimes are flexible and service users choose their own clothes and if needed personal care is given. Both service users confirmed that Mr Mrs Hawkins knock bedroom doors and respect privacy. One service user requires support with some personal care. On the day of the inspection both service users appeared to be very well attired and were wearing fashionable clothes. It was evident that Mr Mrs Hawkins are aware of the needs of the service users. Service users are registered with local GP’s and are assisted to attend appointments if they wish to have support. One service user stated that they make their own appointments with the GP. Personal files contain details of appointments with other appropriate health care professionals. One service user takes regular medication, which is administered by Mr Mrs Hawkins. All medication is kept in a locked cupboard and Medication Administration Records are kept (MAR), the Inspector saw these records. It 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 14 was noted that the MAR sheets did not contain the amount of medicines being kept in the home and that variable doses were not being recorded. These matters were discussed with Mrs Hawkins at the time of the inspection and must be addressed. 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 23 The outcome group is Adequate. There is an open atmosphere in the home and service users are able to raise any worries or concerns with the owners. The home maintains records of service users finances as needed, however these processes must be reviewed to ensure that they are robust. EVIDENCE: The home has a Complaints policy and there is a copy of the Somerset County Council “Safeguarding Vulnerable Adults” policy. The home operates very much in the style of a family-type environment. One service user was able to clearly state what they would do if they had any worries or concerns. Both service users have regular access to professionals and family outside the home if for any reason they felt unable to discuss an issue with the owners. One service user’s money is managed by the home and the parents of the other service user manage their finances, as they are the appointee. Mrs Hawkins stated that the home does not keep any service user’s money at the home and if personal spending money were required this would be obtained on that day by accessing the Building Society. The home keeps very basic records in the relation to the management of the service user’s finances. After discussions, the Inspector stated that Mrs Hawkins must review how the home manages service users finances and to ensure that the policy and processes are robust and can easily demonstrate an audit trail. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 16 The home does not use physical intervention or breakaway techniques, as this is currently not required. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 17 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 26 27 28 29 30 The outcome group is Good. 201a Berrow Road provides comfortable and very homely domestic accommodation for both service users. EVIDENCE: 201a Berrow Road is a very well maintained domestic dwelling. It is within walking distance of the sea front and there are local transport links. Mr Mrs Hawkins live on the premises and have some private accommodation which is not accessible to service users. On the ground floor there is a lounge for the exclusive use of the owners and another for the service users. There is also a large conservatory that leads onto a beautifully maintained rear garden that has a summerhouse. There is a domestic style kitchen and domestic style laundry facilities located in a utility area. Bedrooms are for single occupancy and are all are located on the first floor. There is no lift so all service users need to be physically able. Both service users currently living at the home showed their bedrooms to the Inspector. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 18 Both were comfortable and reflected the individual needs and preferences of the individual. There is a bathroom and two toilets on the first floor and another toilet on the ground floor. Appropriate locks are fitted. Presently, no aids or adaptations are needed to meet specific needs of the service users. All areas of the home were very well maintained, homely and clean at the time of the inspection. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 19 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): No staff are employed at the home therefore no core standards in this section have been assessed at this inspection. EVIDENCE: 201a Berrow Road DS0000016279.V303457.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37 42 The outcome group is adequate. The home appears to be well run. Service users speak well of Mr Mrs Hawkins. The home promotes health and safety but needs to address some matters to further promote this. EVIDENCE: The Registered Manager is Veronica Hawkins, however the home is run in partnership with her husband. Mr Mrs Hawkins live on the premises and both provide care and support to the service users. No other staff are employed. Mrs Hawkins has worked in the care sector for many years and has a National Vocational Qualification in Care at level 2. The Inspector spent some time discussing with Mrs Hawkins how she keeps herself updated with good practice. At the previous inspection it was recommended that Mrs Hawkins should undertake further NVQ training. This has not been pursued and still remains a recommendation. 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 21 Mr Mrs Hawkins were able to demonstrate a good knowledge of the service users needs and appear to have created a comfortable and open atmosphere. The Inspector viewed some documentation in relation to health and safety. The home maintains records of the temperature of the fridge and freezers however, there were some gaps in dates and Mrs Hawkins stated that this would be addressed. Mrs Hawkins has Basic Food Hygiene and First Aid Training. It is recommended that Mr Hawkins attend both of these courses. This will promote health and safety in the home. As the home is very domestic in style the home only has smoke detectors fitted. These are tested on a monthly basis with records kept. The home must conduct a Fire Risk Assessment. The Gas Safety Certificate is dated 09/01/06. The Electrical Hardwiring Certificate is dated 25/11/02. It appears that a number of recommendations were advised at the time of issue. It is unclear if the recommendations have been actioned. The home must address this and advise the CSCI. The hot water outlets are fitted with thermostatic valves. In line with providing a family type environment the service user’s bedroom windows are not restricted and wardrobes are not secured. Adequate Insurance has been obtained. There have been no recorded accidents at the home since 31.03.04. 201a Berrow Road DS0000016279.V303457.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 2 2 X 3 X 4 X 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 2 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 X 1 X LIFESTYLES Standard No Score 11 2 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 1 X 3 X X X X 1 X 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 23 N/A 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 YA1 Regulation 6 Requirement The Registered Manager must ensure that the Statement of Purpose and Service User Guide are updated. The Registered Manager must ensure that service user’s plans are kept under review and reflect the current needs of the individuals. Any restrictions or limitations imposed on service users must be included in their care plan. The Registered Manager must conduct detailed risk assessments to ensure that service users are not put at unnecessary risk. The Registered Manager must ensure that the quantities of all medicines that come into the home are recorded on the MAR sheets and variable doses are recorded to confirm the actual amount of medicine administered. The Registered Manager home must conduct a Fire Risk Assessment. Timescale for action 30/11/06 2 YA6 15 (2) 31/10/06 3 YA9 12 (1) (a) 13 (4) (b) (c) 13 (2) 06/10/06 4 YA20 22/09/06 6. YA42 23 13 (4) 31/10/06 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 24 7. YA42 13 (4) The Registered Manager must ensure that the electrical hardwiring of the home is satisfactory. 30/11/06 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. 3. 4. Refer to Standard YA11 YA17 YA37 YA42 Good Practice Recommendations Service users should be encouraged to develop independent living skills by undertaking further household tasks. The home should keep individual records of meals provided to service users. The Registered Manager should undertake further NVQ training. Mr Hawkins should attend training in food hygiene and first aid 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 201a Berrow Road DS0000016279.V303457.R01.S.doc Version 5.2 Page 26 - 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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