Inspection on 10/05/05 for 4 The Grove

This inspection was carried out on 10th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

4 The Grove 30/01/09

4 The Grove 07/03/07

4 The Grove 25/10/05

4 The Grove 23/11/04

4 The Grove 29/04/04

4 The Grove 02/12/03

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 4 The Grove Westoning Beds MK45 5JW Lead Inspector Ansuya Chudasama Announced 10 May 2005 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 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 Stationary 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. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service 4, The Grove Address Westoning Beds MK45 5JW Telephone number Fax number Email 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 718025 MacIntyre Care Margaret Banks Care Home 6 Category(ies) of LD - Learning Disability registration, with number of places 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd November 2004 Brief Description of the Service: 4 The Grove is a purpose-built two storey home accommodating six service users with learning disabilities. The property is owned by MacIntyre Property and operated by MacIntyre Care. The first floor of the home consisted of service users bedrooms and two bathing facilities with toilets. The ground floor had a staff room with en suite facilities, snoezelem, kitchen, dining room, lounge, and laundry. The home was situated with two other purpose-built homes belonging to MacIntyre Care in an enclosed courtyard, which provided parking. At the rear of the house is an enclosed garden with a patio area and a sensory garden. The home was in walking distance of the village with its shops and pubs. The home had its own mini-bus. The home provided comfortable accomodation on a domestic scale and met the needs of the service users. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection was undertaken at 09.30, and it took place over 6 hours. The registered manager, Margaret Banks was present at the inspection. The inspection was comprised of a tour of the communal areas, two service users’ bedrooms, talking to staff and link workers of service users, and talking to service users. Two service users’ case records and other documents were inspected in detail. There were six male service users living at the home at the time of the inspection. What the service does well: The manager was experienced and ran the home to a high standard. The staff were very motivated and understood the needs of the service users well. They also worked well as a team and enjoyed working at the home. They worked well with service users and had build up a good working relationships with them. Service users were observed approaching staff in a happy and relaxed manner. Their rooms were individualised to meet their needs. They enjoyed a variety of activities in the home and in the community. They were encouraged to pursue their hobbies. Person Centred Planning (PCP) information was in picture format that service users could understand and discussed service users hopes, dreams and people that supported them. The service users, guide was excellent and in picture format. Families of service users stated in the service users questionnaires that the staff were excellent and had friendly attitudes. A letter read from a service users family stated “thank you all for the love and care you give him”. Excellent training was provided by the organisation and this was linked to meeting the needs of service users. The home worked very closely with families/relatives. Service users’ care records were well maintained and easy to read. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 standard(s) 1,2,3,4,5, The homes statement of purpose and service user’ guide are excellent providing prospective service users and their families information of the services the home provides enabling an informed decision about admission to the home. EVIDENCE: The home had not admitted any new service users since it was opened. The manager stated that the service users and their families and social services had been involved in the process of moving service users to the home. All the service users had lived together in previous Macintyre homes and had grown up together. The organisation had policies and procedures on the admission procedures. The home had an excellent service user’ guide and this was very colourful and had pictures and objects that the service users were familiar with in the home and in the community. The staff and service users were involved in producing this document. Each service user had a contract, which contained all the information required, and the manager and service users signed this. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 standard(s) 6,7,8,9,10 There was clear and consistent care planning systems in place to provide the staff with the information they needed to meet the needs of the service users to a high standard. EVIDENCE: The care plans of two service users were inspected in detail. Evidence showed that the care plans were detailed and contained all the information about the service user’ personal, social and health care needs. The information was clearly laid out and easy to read and follow. The plans were signed and dated by all the people that were involved in drawing them up. The service users were not able to sign but it was good to see that they were being encouraged to make their mark to make them feel part of the process. Link workers reviewed the plans aims and objectives on a monthly basis. The home had started completing Person Centred Planning (PCP) for each service user. The PCP seen for service users case tracked were very good and were completed in pictorial form. The staff provided service users with information by using different methods of communication. For example they used verbal communication, pictures, objects, and makaton sign language to help them make decisions about 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 10 choosing meals, activities, clothes, ornaments, items for their rooms and for communal areas. Risk assessments were undertaken on all service users. Those seen were detailed and reviewed and monitored by management. Staff also completed a detailed checklist on risk assessment. Staff spoken to had completed training on confidentiality in their induction training. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 standard(s) 11,12,13,14,15,16,17 Service users have opportunities for personal development to enrich their social and educational opportunities. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets service users tastes and choices. EVIDENCE: The service users were able to express their choices and preferences in most areas of their care with support from staff. The home had an activities board to record activities that the service users had been involved in. It was also used to ensure that all service users were being involved in activities. The manager monitored this information. Service users’ families stated that the staff offered them choices and holidays. Two service users’ care plans inspected had detailed information on service users likes and dislikes of activities in the home and in the community. They attended the adult training service run by the organisation four days a week. The home worked closely with the training centre and had developed a 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 12 communication book for each service user so they could communicate with the centre about the needs of the service users. The service users had a day back at the home to work on their personal development skills with their link worker. Their activities list showed that they enjoyed a variety of leisure activities. The home did not hold service users meetings due to their autism and challenging behaviour, they were not able to concentrate on tasks for long periods. However they choose the menus on a weekly basis by using pictures and by staff having knowledge of their likes and dislikes and by trying new meals to find out if they liked them. The menus were displayed in pictures were varied and nutritious. Records showed that service users were encouraged to maintain contact with families by visits, by telephone and by writing. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 standard(s) 18,19,20,21 The knowledge of staff, safe systems for administering medication and detailed care planning meant that the health needs of service users are met. EVIDENCE: Service users’ plans showed that their personal care needs were being met and how the care was given was recorded in detail and included having routines for the mornings and evenings. The routines were flexible and service users also liked having routines as they felt happy and comfortable and knew what was going to happen. The staff spoken to were also aware of the service users routines. Service users health care records were well recorded and gave an overview of their health needs and discussed how staff with support from the professionals helped to keep them healthy. Medication reviews were also undertaken and staff that gave out medication had received this training. The appointments attended were dated, signed and the outcome of the visit was recorded. The service users PCP also had information about service users health care needs in picture format. The comments received from families stated that staff respected service users and treated them well. This was observed on the day of the inspection. Service users burial arrangements were recorded in their files. One service 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 14 user was helped by staff and specialist services from Twinwoods to deal with his bereavement process. The service user was also given a video on bereavement to help him understand and help him deal with his loss. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 standard(s) 22,23 The staff have good knowledge and understanding of adult protection issues, which protect service users from abuse EVIDENCE: Comments from questionnaires completed by families stated that the staff were caring, friendly, and their views and concerns were always listened to. The families also understood the complaints procedures. The staff spoken to were asked how they would be able to know if a service user was unhappy or being abused. It was stated by staff that they understood the service users well. They would also be able to know if some thing was wrong by the way the service users behaved, the words used by them, and if they showed signs of being withdrawn. An example given was of a service user who had lost his mother. The service users’ plans read had reduction methods put in place to safe guard service users from potential abuse. The care records also had information recorded on how service users communicated, and what some of the words and behaviours meant when used by them. The home had basic complaints policy in the service users guide and this was also displayed in the home. The organisations policy needed reviewing. The home had received one complaint and this was dealt with satisfactory. The staff had a list of behaviours that the service users displayed when they were unhappy. The concerns were recorded and resolved by staff, and management monitored this process. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24,25,26,27,28,30 The premises were well maintained so as to allow all those living at the home to enjoy a homely and comfortable environment that was safe, clean, and hygienic. EVIDENCE: The home was clean and well maintained and families confirmed this in their feedback. The premises were suited to meet the needs of the service users and decorated to a high standard. They were observed accessing all parts of the communal areas safely. The manager had received a grant from the organisations innovation fund and had a patio completed in the front of the house. This looked very nice and service users were observed sitting out on this. All service users had single rooms and they were individualised to meet their needs. The staff helped service users to pursue their hobbies and helped them choose their pictures, ornaments and decorations for their rooms. One of the service users room seen had lots of sensory items and different kinds of textures that the service user enjoyed touching. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 17 The Environmental Health Officer had visited the home on the 20.1.05 and stated that there was a problem of slow drainage in the wash hand basin that was located in the kitchen. The manager stated that the kitchen was going to be replaced by a new one in September 2005. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36 The home provided very good training so that the people living at the home had their needs met by competent and suitable staff. EVIDENCE: The staff members spoken to stated that the team was more settled and had bonded well together. Prior to when they had first started, the home had vacancies and relief and agency staff worked this. The home was now fully staffed and provided continuity to service users. It was stated that the service users were also well settled. Service users’ accident and incidents recorded had been reduced and it was stated by staff that , “every thing was ticking well”. The staff enjoyed working with the service users and had got to know them and their needs well. Observations also showed that the staff were very motivated and had build up good working relationships with service users. The staff stated that they received monthly supervisions. The home has six service users with high needs and service users required a high level of care from staff. The home has two staff on duty per shift. The manager needs to undertake an assessment of the staffing levels to find out if two members of staff are adequate to meet the needs of service users. The staff stated that they had completed the organisations induction and the Certificate in Working with People with Learning Disabilities training. The 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 19 mandatory training in the required areas was also completed. It was stated that the training provided by the organisation was very good and one staff had completed their NVQ level 3 and the other staff was waiting to start hers. This was confirmed by inspecting staff training records. The staff spoken to were link workers to service users and they gave detailed information on how they meet the needs of the service users. They were also aware of the needs of other service users. The staff also held link worker meetings to discuss progress on how service users aims and objectives were being met. The staff recruitment records seen were mostly satisfactory, however, one reference seen did not have any information, except the name and date when employed by the organisation. One staff member’s birth certificate or photocopy of current passport was not available. The manager was going to discuss this with her operations manager. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,39,40,41,42.43 The home has an experienced and committed manager who ensures strong leadership, and safe working practices so that service users health, welfare and safety are safeguarded EVIDENCE: The achievements of the manager since her appointment were evident. The manager had worked very hard to get a full complement of staff to maintain continuity for service users to meet their needs. Evidence from the inspection showed that the manager ran the home to a high standard. It was stated by staff that the manager was very supportive, approachable and good. They were encouraged to put forward their views and ideas in meetings. The home had an annual development plan. The Investors in People was undertaken every two years. The operations manager on a yearly basis completed the Investors in Care by case tracking a service user in the home. The next one was due in November 2005. Families on behalf of service users 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 21 and other professionals involved with the service users had completed a questionnaire called improving our service. The outcome received was very positive. The manager and staff spoken to stated that all service users were aware when they heard the fire alarm bell that they had to go out. One service user was frightened by the noise and staff supported the person. All service users had risk assessments undertaken on fire evacuation. The staff spoken to stated that fire drills were undertaken on a two monthly basis. The home had regular health and safety checks, and audits undertaken on a monthly basis and management monitored these records. 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 4 3 3 3 3 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 4 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 4 3 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 3 4 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 4 The Grove Score 3 3 3 3 Standard No 37 38 39 40 41 42 43 Score 3 4 3 3 3 3 3 I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 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. 1. 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 Good Practice Recommendations 4 The Grove I51 S14907 4 The Grove V213999 100505 - Stage 4.doc Version 1.30 Page 24 Commission for Social Care Inspection Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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