CARE HOME ADULTS 18-65
201a Berrow Road Burnham-on-sea Somerset TA8 2JF Lead Inspector
Jane Poole Unannounced Inspection 24th January 2006 10:00 201a Berrow Road DS0000016279.V279746.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 201a Berrow Road DS0000016279.V279746.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. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 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.V279746.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 23rd August 2005 Brief Description of the Service: 201a Berrow Road is registered to provide personal care for up to 3 people with learning difficulties. The home is owned by Mr and Mrs Hawkins and is managed by Mrs V Hawkins. Both owners live at the home and provide all care, no staff are employed. The house itself is a spacious family style home 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 meaning that service users need to be physically able. All bedrooms are for single occupancy and bathroom facilities are shared. There are currently two service users who live permanently at the home. The home operates family style living and is appropriate for the current service users. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection was carried out over a 1.5 hour period. There currently two service users living at the home and the owners have no plans to accept any new referrals at this time. The inspector was able to speak with the owners and both service users. What the service does well: What has improved since the last inspection?
Since the last inspection there has been a full review of the needs of one service user. As a consequence of this review risk assessments have been put in place. In line with risk assessments some unassisted activities have ceased and the owners continue to explore various alternative leisure activities with the service user. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 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. 201a Berrow Road DS0000016279.V279746.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 201a Berrow Road DS0000016279.V279746.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): 1 & 5. There have been no changes to the statement of purpose or the service user guide. These documents are brief but appropriate to the home at the current time. EVIDENCE: The Local Authority assists service users living at the home with their fees. Both have financial agreements with the relevant Social Services department. There is a very brief statement of purpose and a leaflet that is given to service users about the facilities available, and what is included in the basic fee. Personal services and items such as toiletries and hairdressing are not included in the fee. Fees charged are dependant on the assessed needs of the individual. No new service users have moved to the home since the last inspection, therefore the majority of standards in this section have not been assessed. 201a Berrow Road DS0000016279.V279746.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): 6, 7 & 9. No staff are employed at the home and the owners are able to demonstrate knowledge of the needs of each service user. The care plans are basic but appropriate to the size and nature of the home. EVIDENCE: No staff are employed at the home and all care is carried out by the manager and her husband. Both are extremely familiar with the needs of the service users. Each person has a care plan, which gives basic details of the needs of the service user and includes their likes and dislikes. The inspector noted that one service user had a copy of their care plan in their room. The home keep daily records in respect of service users, these are reasonably comprehensive and give details of social outings and appointments. Since the last inspection, their care managers have visited both service users. One personal file contained details of a full review that had been carried out by
201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 10 the care manager. Some recommendations were made at this review but when spoken to the service user stated that these had not been fully actioned. The home does not act as an appointee for either service user but assists one service user with personal finance. Clear records are kept in respect of this. Both service users are able to go out of the house without the assistance of the owners. Restrictions are in place regarding this activity and such restrictions have been agreed with service users and care managers. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 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, 13, 14, 15 & 17. The home-owners assist service users to maintain contact with friends and family. Service users have opportunities to use local facilities under the supervision of the owners. EVIDENCE: One service user attends day services one day a week and enjoys going out with the owners on other days. No day services are arranged by social services for the other service user. Although the owners have tried to provide meaningful activities for this person many activities, and attendance at clubs, have stopped in line with risk assessments that have been carried out. The home operates in a family style and outings are arranged in line with this, the daily records show that both service users go out shopping, out for meals and visiting relatives. Both service users have had holidays with family members since the last inspection. The home assists one service user to regularly visit an elderly
201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 12 parent and there appears to be excellent liaison between the owners and the family members of both service users. One service user stated that they regularly go to stay with family. One person enjoys going out for a walk each day and the other attends bell ringing sessions three evenings a week. The inspector observed that service users have unrestricted access to their private rooms and communal areas. Both service users choose not to assist with household tasks and the owners accept this. Service users have TV’s in their rooms and are free to choose how they spend their leisure time. Service users stated that they are happy with the food in the home. There are no set menus and food is cooked in accordance with known likes and dislikes. One person said that they liked to eat meals in the kitchen/diner and the other stated that they preferred to eat in their room. Service users have access to the kitchen and are able to make drinks and snacks at any time. 201a Berrow Road DS0000016279.V279746.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 & 20. There are facilities for personal care to be carried out in private. The owners encourage service users to independent with their personal care but assist by prompting and reminding. EVIDENCE: Service users are registered with local GP’s and are assisted to attend appointments if they wish to have support. Personal files contain details of appointments attended and show that service users are accessing dentists and opticians in line with their individual needs. One person has recently been seen by a psychologist. Care plans show the amount of assistance each service user requires to carry out their personal care. People are encouraged to be independent with personal care but the owners assist by prompting and reminding. There is a pleasant bathroom on the first floor where personal care care can be undertaken in private. One service user takes regular medication, which is administered by the owners. All medication is kept in a locked cupboard and Medication Administration Records are kept, these records were seen by the inspector and found to be correctly signed when administered or refused. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 14 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. There is an open atmosphere in the home and service users are able to raise any worries or concerns with the owners. EVIDENCE: As previously mentioned the home operates a family style environment, which allows service users to raise any worries or concerns with the owners. 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. There is a copy of the Somerset County Council “Safeguarding Vulnerable Adults” policy and a formal complaints policy. Both service users stated that if there was anything that they were not happy with they would be comfortable to speak with the manager of the home. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 15 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, 26, 27 & 30. 201a Berrow Road provides comfortable domestic accommodation for service users. EVIDENCE: 201a Berrow Road is a well maintained domestic dwelling. It is within reach of the sea front and local transport links. The owners of the home live on the premises and have some private accommodation which is not accessible to service users. 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. Both were comfortable and very personal to the individual. There is a bathroom and two toilets on the first floor and another toilet on the ground floor. On the ground floor there is a lounge for the exclusive use of the owners and another for the service users.
201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 16 The kitchen is shared by all members of the house and service users are able to make drinks and snacks at any time. There is a domestic style utility room with washing machine and drier, which is appropriate to the needs of the service users. At the time of this inspection all areas of the home seen by the inspector were clean and fresh. 201a Berrow Road DS0000016279.V279746.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): No staff are employed at the home therefore no standards in this section have been inspected. EVIDENCE: 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 18 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. There are adequate measures in place to ensure the health and safety of service users whilst maintaining a domestic style dwelling. EVIDENCE: As stated many times in this report the home runs in line with ordinary domestic practices. The registered manager is Veronica Hawkins but it is managed and run in partnership with her husband. Both owners live on the premises and both provide care and support to the service users. The manager has worked in the care sector for many years and has a National Vocational Qualification in care at level 2. The owners are able to demonstrate a good knowledge of the service users and have created a comfortable and open atmosphere. Both service users spoke fondly of the home-owners. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 19 Appropriate steps have been taken to ensure the health and safety of service users whilst maintaining a domestic dwelling. All areas of the home are well maintained. Smoke detectors are fitted and these are tested and recorded on a monthly basis. Veronica has undertaken courses in first aid, food hygiene and health and safety. Documentation in the home is basic but appropriate to the size and nature of the home. Appropriate insurance is in place. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 20 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 3 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 3 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 3 28 X 29 N/A 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 3 3 X 3 X LIFESTYLES Standard No Score 11 2 12 X 13 3 14 3 15 4 16 X 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 2 X X X X 3 X 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 21 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. Refer to Standard YA37 YA11 Good Practice Recommendations The manager should undertake further NVQ training. Service users should be encouraged to develop independent living skills by undertaking some household tasks. 201a Berrow Road DS0000016279.V279746.R01.S.doc Version 5.1 Page 22 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
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