Inspection on 27/03/09 for 44 Monks Close

This inspection was carried out on 27th March 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

44 Monks Close 06/12/07

44 Monks Close 31/01/07

44 Monks Close 28/04/06

44 Monks Close 27/10/05

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Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: 44 Monks Close 44 Monks Close Bircham Newton Norfolk PE31 6RD     The quality rating for this care home is:   zero star poor service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Alan Buttery     Date: 2 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 22 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 22 Information about the care home Name of care home: Address: 44 Monks Close 44 Monks Close Bircham Newton Norfolk PE31 6RD 01485576062 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs Yvonne Asbury Name of registered manager (if applicable) Provider/Manager Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 learning disability Additional conditions: That the home is registered for one named individual only. Date of last inspection Brief description of the care home Yvonne Asbury provides care and accommodation to an adult with a learning disability who has lived with the family for over seventeen years. It is likely that the service would be eligible to be registered as part of an Adult Placement Scheme 1 Over 65 0 care home 1 Care Homes for Adults (18-65 years) Page 4 of 22 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: zero star poor service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: This report is based on information gathered since the last inspection, and from a meeting with the provider. It did not include a visit to the registered premises. The manner of this registration is not ideal at the present time, and seems to be more suited to an adult Placement type of registration, which was discussed during and after the meeting. The support is funded by Birmingham Social services department and fees are around 500.00 weekly. Care Homes for Adults (18-65 years) Page 5 of 22 Care Homes for Adults (18-65 years) Page 6 of 22 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 7 of 22 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 8 of 22 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. This standard cannot be judged at the present time Evidence: This is a service which provides support to just one person, and there is no likelihood of this situation changing. Care Homes for Adults (18-65 years) Page 9 of 22 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Individual plans are not in place to show how identified needs are being met or reviewed. Evidence: The resident has lived as part of the providers family for many years, and it has previously been noted that no formal care plans are in place. Support is given by either the provider or her daughter. Although some thought has been given to care planning, and was discussed with the provider, there is still no formal plan of care, other than a very basic plan provided by the funding authority many years ago. There is consequently no review of the care that is given either by the provider or the funding authority. Care Homes for Adults (18-65 years) Page 10 of 22 Evidence: The changing living arrangements have also rendered any risk asessments that had been done obsolete. However there was evidence that the residents views are very important to the provider and she is consulted about her care. Care Homes for Adults (18-65 years) Page 11 of 22 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The resident has access to a variety of activities of her choosing Evidence: The provider has been able to arrange some formal daytime activity over the past year, although the living arrangements, and location of the registered property do make this more difficult. The resident is treated as part of the family, and enjoys family activities, walks, helping with the providers pets, and is supported to visit her family on a regular basis. As the living arrangements are resolved, a more structured programme of activities can be put in place, subject to funding arrangements being made. Care Homes for Adults (18-65 years) Page 12 of 22 Care Homes for Adults (18-65 years) Page 13 of 22 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Support suited to the resident is provided with access to health professional as needed Evidence: Support is provided solely by the provider and her daughter, and the resident is registered with a GP locally. She appeared happy with the arrangements, communicating well with the provider. Although records are kept showing the medication given, no formal process or training is in place. Care Homes for Adults (18-65 years) Page 14 of 22 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Although no formal processes are in place, an awareness of concerns and complaints procedures and safeguarding issues was shown. Evidence: There are no formal procedures in place to manage complaints although the resident of the home appears more than happy with her support. The provider showed an awareness of adult protection issues, but has been unable to access training although a course was paid for, because of her commitments to the resident. Care Homes for Adults (18-65 years) Page 15 of 22 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. These standards were not assessed Evidence: Support was not being provided from the registered address at the time of this report, and these standards could not therefore be assessed. Care Homes for Adults (18-65 years) Page 16 of 22 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service does not employ staff Evidence: Support is provided by either the provider or her daughter, who has a valid CRB in place. No formal training records were available. Care Homes for Adults (18-65 years) Page 17 of 22 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience poor quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The resident receives suitable support in the current circumstances, but this needs to be better planned for the future. Evidence: The resident has lived with the provider as part of her family for almost twenty years, and although not holding formal qualifications, the provider has completed some parts or her NVQ, but has yet to finish it. It was not possible to consider health and safety within the home, as the inspection did not take place at the registered home. However, clearly, the current arrangements cannot continue, as the address being used is unregistered, and the nature of the registration also needs to be considered further as adult placement schemes are now available in the providers area, and would appear to be better suited to this service. Care Homes for Adults (18-65 years) Page 18 of 22 Evidence: The service currently fails to provide much of the formal documentation required under the Care Home regulations. The resident clearly showed a close affinity to the provider, and expressed how satisfied she is with the support given. Care Homes for Adults (18-65 years) Page 19 of 22 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 20 of 22 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Individual care plans must be in place To show how the needs of the resident are being met 31/05/2009 2 9 15 Risk assessments must be in 31/05/2009 place To show how support is provided in a safe manner 3 37 12 All the information detailed in the regulations must be available To ensure that the individuals needs are detailed and met 30/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Adults (18-65 years) Page 21 of 22 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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