Inspection on 31/01/07 for 44 Monks Close

This inspection was carried out on 31st January 2007.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

44 Monks Close 27/03/09

44 Monks Close 06/12/07

44 Monks Close 28/04/06

44 Monks Close 27/10/05

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 44 Monks Close Bircham Newton Norfolk PE31 6RD Lead Inspector Mrs Lella Andrews Unannounced Inspection 31st January 2007 10:50 44 Monks Close DS0000062976.V329343.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 44 Monks Close DS0000062976.V329343.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. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 44 Monks Close Address Bircham Newton Norfolk PE31 6RD 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) 01485 576062 Mrs Yvonne Asbury Not applicable Care Home 1 Category(ies) of Learning disability (1) registration, with number of places 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. That the home is registered for one named individual only. Date of last inspection 28th April 2006 Brief Description of the Service: 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 but Norfolk does not have such a scheme and so the service is registered as a Care Home. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report contains information about the Home that has been gathered since the last Inspection and includes an announced visit to the Home on the 31st January 2007 between 10.50am and 12.10pm. The visit did not take place at the registered address as Mrs Asbury and the client are currently staying at an alternative address for a few weeks. During the visit the Inspector was shown around the house, spoke to Mrs Asbury and the client and looked at some records. It would be more suitable for this service to be registered as part of an Adult Placement Scheme but as there is currently no such scheme available in Norfolk it must be registered as a Care Home and be inspected against the relevant Regulations and National Minimum Standards. The inspection focuses on the outcomes for the client and the report reflects this. Any requirements and recommendations made are those which the Inspector feels are most relevant and appropriate for this service rather than highlighting every instance that a regulation or standard has not been met. The fees for this service have been individually negotiated with the purchasing authority and are currently approximately £600.00 per week. What the service does well: The client has lived with the Proprietor and her family since she was a child and feels that she is part of the family. The client appears to be happy and settled living with the Proprietor. The client has pets which she says she likes helping to look after. Despite difficulties with transport, the Proprietor makes a big effort to ensure that the client is not isolated and that she can take part in leisure activities that she enjoys. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. 44 Monks Close DS0000062976.V329343.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 44 Monks Close DS0000062976.V329343.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. This service is only registered for one named client and so there is no need for the Proprietor to have an assessment process in place. EVIDENCE: 44 Monks Close DS0000062976.V329343.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, 8 and 9 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The client does not have a care plan but as the Proprietor and her daughter are the only care providers and know her well this does not cause the client any difficulties The Proprietor considers risks prior to making decisions affecting the client The client feels that she is involved in making decisions about issues that affect her. The Proprietor looks after the clients money and it is clear that the resident has money to spend on items of her choosing. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 10 EVIDENCE: The client has lived as a part of the Proprietors family for many years and so the Proprietor and her daughter, who are the only care providers, know the client well. Therefore the absence of a care plan does not cause any difficulties for the client. The Proprietor keeps a daily diary which contains information about how the client has spent her day and any other relevant information relating to the clients life. The Proprietor said that there are still problems with the client accessing her benefits and so the Proprietor is using her own money to make purchases for the client. The Proprietor is keeping all receipts but has not yet started to maintain a written record of expenditure on behalf of the client. The client clearly has money to spend on items of her choosing. The Proprietor has completed written risk assessments relating to the environment of their home but no further written risk assessments have been completed. However, the Proprietor considers risks to the client before making decisions about issues affecting her. The client feels that she is part of the family and in conversations with her it is clear that her views are sought over issues affecting her. 44 Monks Close DS0000062976.V329343.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, 16 and 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The client has started to attend a formal day service but there are difficulties with accessing this due to the location of the Home. The client is supported to take part in social activities within the community but this is limited by the location of the Home and the lack of public transport. The client is supported to maintain contact with family and friends The clients rights are respected The client said that she enjoys her meals. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 12 EVIDENCE: The location of the Home is in a very rural area which has little public transport and the Proprietor does not have a car. The Proprietors daughter provides transport on occasions and the Proprietor and the client stay with another relative who lives in Norwich which enables them to access facilities in the city. Over the last few months the Proprietor has been trying to arrange a move but as the house belongs to the local authority this is proving difficult. The Proprietor and the client are currently staying at a house in a local small town which enables the client to be able to walk to local shops and other facilities. In recent months the client has started to attend a day service which is located approximately thirty miles from the Home. This means that accessing the service is difficult and involves the Proprietor and client spending a lot of time on the bus. The purchasing authority are in the process of looking into funding for transport to the day centre. The town in which the Proprietor are currently staying is a lot nearer to the day service and there is a much more regular bus service. The client has recently stayed at a respite care home in the county which she moved from which has enabled her to visit her family over Christmas. The client spends a lot of time with the Proprietors family and has regular holidays abroad. The client is involved in choosing what she eats and said that she likes the Proprietors cooking. 44 Monks Close DS0000062976.V329343.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 and 20 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The clients receives support in the way that she prefers. The client is supported to access health appointments as necessary Records are now being kept of the receipt and administration of medication. EVIDENCE: The Proprietor, and on occasion, her daughter are the only people who provide care to the client and they both know her very well. The client considers that she is part of the Proprietors family and is treated as such. She said that she is happy with the help that she gets from the Proprietor. The client has visited the dentist and GP as she has needed to over the last few months. The daily diary includes information about any health appointments that the client has had. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 14 The Inspector saw the records relating to the receipt and administration of medication and these are satisfactory. It is recommended that the Proprietor attends training relating to the administration of medication. 44 Monks Close DS0000062976.V329343.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): 22 and 23 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The client feels that her views are listened to and that the Proprietor will sort out any problems. There is a need for the Proprietor to undertake training with regard to Safeguarding Adults. EVIDENCE: The Home does not have a formal complaints procedure and the client would find this difficult to use. The clients feels that she is part of the family and said that the Proprietor would sort out any problems. The client has started to attend a day service and so means that there are now people, other than the Proprietors family, who are involved in her life. The Proprietor has a good understanding of the vulnerability of the client and the risks attached to the clients lack of understanding of certain situations. The Proprietor said that she has recently found somewhere more local where she can access training and intends to undertake Safeguarding Adults training there as soon as possible. The requirement with regard to this is repeated in this report. 44 Monks Close DS0000062976.V329343.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 and 30 Quality in this outcome area is poor This judgement has been made using available evidence including a visit to this service. The Home does not meet the needs of the client due to its size and location but it does provide warm, comfortable accommodation for the client. The Proprietor and the client are currently staying at another address which is an improvement in respect of its size and location. EVIDENCE: The Home is a two bedroom local authority house located on a housing estate in a very rural location with little public transport. There are no shops or other amenities within walking distance. As previously mentioned in this report this causes difficulties for the client in accessing leisure and educational facilities. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 17 The Home only has two bedrooms and the Proprietors daughter also lives there. There are occasions when the client shares a bedroom with the Proprietor which is unacceptable. The Proprietor has spent the last few months liaising with the housing department in an attempt to move to a more suitable house in a different location. The Proprietor and the client are currently staying at another house which is located in a small town with shops and other amenities close by. The visit was carried out at this address and the client showed the Inspector around the house. There is only the Proprietor and client living at this address. The house has three bedrooms. A requirement is made for a risk assessment to be carried out for this accommodation. Some areas of the house are in need of redecoration but it is warm and provides comfortable accommodation for the client. The client has her own bedroom. The house has a large garden to the front and a small paved area to the rear. The client would not be able to use the rear garden as it is currently being used by the dogs. 44 Monks Close DS0000062976.V329343.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): Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The Home does not employ any staff. EVIDENCE: The Proprietor is the main carer for the client but her daughter does, on some occasions, provide support for short periods of time. A CRB disclosure has been seen for the Proprietors daughter and she is currently undertaking NVQ Level 2. 44 Monks Close DS0000062976.V329343.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 and 42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The Proprietor has provided care for the client for over seventeen years and the client is happy living with the Proprietor The client feels that her views are listened to. The Proprietor needs to undertake further training. A risk assessment needs to be carried out for the house in which the Proprietor and client are currently staying. 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 20 EVIDENCE: The client has lived with the Proprietor and her family for over seventeen years, since she was a child. The Proprietor does not have any formal qualifications but is in the process of undertaking NVQ training. As previously mentioned in this report, the Proprietor has made contact with a more local training provider and intends to undertake training with regard to First Aid and Food Hygiene shortly. The Home does not have a formal quality assurance process but the client is involved in discussions affecting her and the rest of the household. The Proprietor has taken steps to protect the health and safety of the client, for example, there are smoke detectors around the Home. It is required that a risk assessment is undertaken for the house in which the Proprietor and the client are currently staying and any safety measures which might be necessary are taken. 44 Monks Close DS0000062976.V329343.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 X 2 N/A 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 2 23 2 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 2 STAFFING Standard No Score 31 N/A 32 N/A 33 N/A 34 N/A 35 N/A 36 N/A CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 1 2 3 2 X LIFESTYLES Standard No Score 11 X 12 2 13 2 14 X 15 2 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 2 X 2 X 1 X X 2 X 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 22 yes 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 YA23 Regulation 13(6) Requirement The registered person must attend training with regard to the protection of vulnerable adults (Safeguarding Adults) The previous dates of 31/01/06, 31/08/06 and 31/12/06 not met. Timescale for action 31/03/07 2. YA42 13 (4) The registered person must carry 02/02/07 out a risk assessment for the house in which they are currently staying 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 YA20 Good Practice Recommendations It is recommended that the Proprietor attends medication training 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Norfolk Area Office 3rd Floor Cavell House St. Crispins Road Norwich NR3 1YF 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 44 Monks Close DS0000062976.V329343.R01.S.doc Version 5.2 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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