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Inspection on 27/01/09 for 201a Berrow Road

Also see our care home review for 201a Berrow Road for more information

This inspection was carried out on 27th January 2009.

CSCI found this care home to be providing an Adequate service.

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.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

CARE HOME ADULTS 18-65 201a Berrow Road 201a Berrow Road Burnham-on-sea Somerset TA8 2JF Lead Inspector Jane Poole Unannounced Inspection 27th January 2009 10:00a 201a Berrow Road DS0000016279.V373944.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.V373944.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.V373944.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 201a Berrow Road Address 201a Berrow Road Burnham-on-sea Somerset TA8 2JF 01278 786358 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) 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.V373944.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st August 2008 Brief Description of the Service: 201a Berrow Road is registered to provide personal care for up to 3 people who have a learning disability. Mr and Mrs Hawkins own the home and the Registered Manager is Mrs Veronica Hawkins. Both owners live at the home and provide all care and support. The home is 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 for single occupancy. People living at the home share a family type bathroom with a bath and overhead shower. People who live at the home are able to use a separate small lounge and dining room on the ground floor. There is a large rear garden that has a summerhouse and hot tub. Fees range between £490.78 - £851.19 each week. This sum does not include the purchase of toiletries, clothes or monies to engage in social activities or hobbies. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the people who use this service experience adequate quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector. We, the Commission, were able to talk with the owners, view records and tour the building. The people who live at the home were not available on the first day of the inspection, therefore the inspector returned to conclude the inspection and speak with the residents two days later. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report What the service does well: What has improved since the last inspection? Since the last inspection the home have completed an improvement plan and worked towards meeting the requirements of the last inspection. Care plans and risk assessments have been up dated in consultation with the people who live at the care home and their care managers. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 6 To minimise the risks of financial abuse an independent accountant is now auditing personal finance records. The home has changed to a monitored dosage system for medication and the registered manager has completed a short course on the administration of medicines. Infection control procedures have been reviewed and personal items such as bars of soap and razors have been removed from the communal bathroom. 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. 201a Berrow Road DS0000016279.V373944.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.V373944.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): 1 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has a statement of purpose and service user guide, which are appropriate to the home. EVIDENCE: No new people have moved into the home for several years and the registered providers state that they do not intend to admit any new people. Therefore these standards have not been assessed on this occasion. 201a Berrow Road DS0000016279.V373944.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 adequate. This judgement has been made using available evidence including a visit to this service. Care plans are personal to the individual and appropriate to the size of the home. People are able to make choices about their day-to-day lives. EVIDENCE: Since the last inspection care plans and risk assessments have been reviewed and up-dated. People living at the home and their care managers have been involved in the review of care plans. Both care plans were viewed, they are basic in nature but appropriate to the size of the home. Care plans seen set out any restrictions in place and these had been agreed and signed by the person living at the home. Risk assessments identify the level of risk and the control measures in place. Since the last inspection these have been made more specific to individual risk. The registered manager needs to ensure that 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 10 care plans and risk assessments are up dated and amended as needs and wishes change. The manager of the home assists people with personal finance and acts as a financial appointee for one person. Since the last inspection the records relating to personal finance have been made clearer and an independent accountant is auditing the records on a monthly basis. Records relating to the finances of one person were viewed. Records seen correlated with monies held. Both people living at the home are able to make choices about their day-today lives within the limitations set out in their care plans. People are able to decide how they spend their time and running records seen give evidence of this. People living at the home said that they were able to do what they like “within reason.” 201a Berrow Road DS0000016279.V373944.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): 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. People living at the home receive support to access leisure facilities and local amenities. People are assisted to maintain contact with family and friends. EVIDENCE: Daily routines in the home are flexible. People who live at the home are able to decide how they spend their time. Both have TVs in their rooms and one person has a DVD player, play station and music centre. There is a TV and video in the downstairs lounge for people to use as they wish. One person receives additional support from the local authority to access local facilities and participate in activities away from the home. On the first day of 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 12 the inspection, both people living at the home were out, one person was out with their support worker and the other was out with a friend. Since the last inspection people living at the home have had holidays away with family members. The home assists people to keep in touch with family by phone and visits. One person said that the owners often took them to visit an elderly parent. Both people living at the home have unrestricted access to their personal rooms, a downstairs lounge, the kitchen and garden. People living at the home said that they attend social clubs, go for meals out and shop for personal items in the local town. One person continues to pursue their hobby of bell ringing. Both people at the home are able to go out of the home without support from the owners. One person enjoys walking in the local area and the other rides a bike. There is no set menu but food is prepared in line with peoples’ likes and dislikes. People living at the home are able to make drinks and snacks at anytime. All meals are recorded. Both people living at the home were happy with the meals served in the home. 201a Berrow Road DS0000016279.V373944.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 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People living at the home have access to healthcare professionals according to their individual need. EVIDENCE: Care plans give details of the level of support that people require with personal hygiene. There is a family type bathroom where people can attend to their personal care in private. Both people living at the home are registered with local GPs and dentists. People are able to attend appointments alone or with the support of the home owners. All appointments are recorded in individual care plans. People access specialist health and social care professionals according to their individual need. One person living at the home takes regular medication, which is administered by the registered manager. Since the last inspection the home has moved to a Monitored Dosage System with printed administration records for medication. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 14 Medication records were viewed and found to be well maintained and correctly signed. The registered manager has also completed a short course on the administration of medication. 201a Berrow Road DS0000016279.V373944.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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The procedure for managing personal finance has improved and safeguards have been put in place to minimise the risks of abuse. EVIDENCE: The home has a complaints procedure and a copy of the local authority policy on ‘Safeguarding Vulnerable Adults.’ Both people living at the home have regular contact with family and professionals outside the home and annual reviews are carried out. No complaints have been received by the home, or the Commission for Social Care Inspection, since the last inspection. As previously stated people living at the home have unrestricted access to their bedrooms and communal areas. Financial records are now being audited by an independent accountant. Both people living at the home said that they would be happy to talk to the manager or their social worker if they were unhappy about any aspect of their care. 201a Berrow Road DS0000016279.V373944.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 201a Berrow Road provides a comfortable homely environment for the people who live there. EVIDENCE: 201a Berrow Road is a large detached house in a residential area. It is within walking distance of the Sea front and close to Burnham town centre. The owners, Mr and Mrs Hawkins, live at the property and have a private lounge and conservatory. All areas are domestic in style. One the ground floor there is a kitchen/diner and lounge that can be used by people living at the home. Bedrooms are on the first floor. There is no lift so people living at the home need to be physically mobile to access the bedrooms. Since the last inspection some bedroom furniture and furnishings have been replaced. People are able 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 17 to personalise their rooms if they wish to. One bedroom seen was extremely personal. Both people living at the home said that they were happy with their room and furnishings. People share a communal bathroom with bath and shower over. A requirement was made at the last inspection to review infection control procedures within the home with particular regard to the communal bathroom. People living at the home have now removed all personal items such as razors and bars of soap and liquid soap has been made available. There is a small utility area with washing machine and drier in line with domestic style living. All areas of the home seen were clean and fresh. 201a Berrow Road DS0000016279.V373944.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): EVIDENCE: All care is provided by Mr and Mrs Hawkins, there are no other staff employed, therefore this outcome group has not been assessed at this inspection. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The registered manager needs to attend regular training courses to ensure their knowledge is kept up to date. EVIDENCE: The registered manager of the home is Veronica Hawkins who runs the home in partnership with her husband. Both live on the premises and are therefore available 24 hours a day. Mrs Hawkins has many years experience of working in the care sector and has completed a National Vocational Qualification (NVQ) in care at level 2. She has an up to date first aid and food hygiene certificate and has recently completed a short course on the administration of medication. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 20 Since the last inspection Mrs Hawkins has been in touch with a local training provider and is hoping to keep her knowledge up to date by attending further short courses and by use of the internet. There are no formal quality assurance systems in place but the providers state that they seek the views of people living at the home on an informal basis. Records of reviews carried out with care managers demonstrate that people living at the home are happy with the service provided. A recommendation of the last inspection was for the home to formally seek the views of people living at the home and other interested parties. There are smoke detectors within the home that are regularly tested and were tested during the inspection. Records show that qualified trades people have tested the electrical installation and gas boiler within the home. Up to date certificates of insurance and registration were seen at this inspection. 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 x 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 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 x 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 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 2 x 2 x x 3 x 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 22 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA6 Regulation 15(2)[b] Requirement Timescale for action 01/07/09 2 YA37 9 (2) [bi] The registered person must ensure that care plans and risk assessments are regularly reviewed and up dated when needs change. The registered manager must 01/07/09 attend periodic training to ensure that their knowledge and practice is kept up to date. 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 Refer to Standard YA37 YA42 YA39 Good Practice Recommendations The registered manager should undertake further NVQ training. (Recommendation made at previous inspection) Mr Hawkins should attend training in food hygiene and first aid. (Recommendation made at previous inspection) The registered persons should seek feedback from people living at the home, relatives and healthcare professionals as part of the quality assurance process. (Recommendation made at previous inspection) 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 23 201a Berrow Road DS0000016279.V373944.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection South West Colston 33 33 Colston Avenue Bristol BS1 4UA 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 201a Berrow Road DS0000016279.V373944.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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!