Inspection on 06/12/07 for 44 Monks Close

This inspection was carried out on 6th December 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 1 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 31/01/07

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 Lella Hudson Unannounced Inspection 6th December 2007 01:30 44 Monks Close DS0000062976.V356275.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.V356275.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.V356275.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.V356275.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 31st January 2007 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.V356275.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 6th December 2007. The visit did not take place at the registered address as Mrs Asbury and the client are currently staying at an alternative address. Mrs Asbury is in the process of deciding where they will live on a permanent basis and is aware of the need to apply for registration at this address if they remain living there. During the visit the Inspector was shown some areas of the Home, saw some records and spoke to Mrs Asbury and the client. The current fees are approximately £500 per week. What the service does well: What has improved since the last inspection? What they could do better: The issue of where the Proprietor lives with the client needs to be clarified. The Proprietor needs to attend training in mandatory subjects, such as Safeguarding Adults. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 6 There is a need for better record keeping. 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.V356275.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.V356275.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: N/A 44 Monks Close DS0000062976.V356275.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. The client does not have a care plan but the Proprietor knows the client well and therefore how to meet her needs The Proprietor considers risks prior to making decisions affecting the client The client has access to her money EVIDENCE: The client has lived as 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 diary in which she records information about how the client has spent her day and any appointments that she has attended. This 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 10 record is not kept daily and the Proprietor is aware of the need to keep better records. The Proprietor said that despite meeting with the clients social worker there are still problems with accessing the clients benefits. However, the client clearly has money to purchase items that she wants to buy on an almost daily basis. The Proprietor is keeping receipts and is aware of the need to keep clearer records about expenditure made on behalf of the client. The Proprietor has completed some risk assessments and is aware of the need to ensure that risk assessments are recorded prior to new activities being undertaken. The Proprietor considers the risks to the client as part of all decision making on her behalf. The client considers that she is part of the family and it is clear that she is consulted about issues that affect her. 44 Monks Close DS0000062976.V356275.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, 15, 16 7 17 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The client attends formal day services for part of the week but there are difficulties with transport The client is able to use local facilities and to become much more a part of the local community at the temporary address The client is supported to maintain contact with relatives EVIDENCE: The location of the registered address is very rural and there is very little, if any, public transport. The temporary address is situated in a small seaside town and the client told the Inspector about a range of places that she goes to on a regular basis and the people that she knows in the town. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 12 The client started attending a day service for two days per week. However, there are problems with transport and so the Proprietor has to take the client by bus. This means that the client is not always able to attend both days each week. Although the client says that she likes the day service her attendance there does cause her some anxieties which has an effect on her behaviour. The Proprietor escorts the client to go back to the Midlands to see her family and to have respite care in a home there. The client spends lots of time with the Proprietors family and has been for a holiday abroad this year. The client is involved in choosing what she eats and said that she likes the Proprietors cooking. There are two dogs and a bird living in the Home and the Proprietor said that she has recently purchased some goats and sheep which are kept locally. The client said that she likes being involved with looking after the animals. 44 Monks Close DS0000062976.V356275.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 adequate This judgement has been made using available evidence including a visit to this service. The client receives support in the way that she prefers The client is supported to access health appointments EVIDENCE: The Proprietor, and on occasion, her daughter are the only care providers for 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 told the Inspector that she is happy living with the Proprietor. The client is registered with the GP and has attended regular dentist appointments. The diary is used to record attendance at appointments. Records are kept relating to the administration of medication. The recommendation for the Proprietor to attend medication training is repeated in this report. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 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 the Proprietor listens to her and sorts out any problems EVIDENCE: The Home does not have a formal complaints procedure and the client would find this difficult to use. The client feels that she is part of the family and said that the Proprietor would sort out any problems. The client attends a day service for part of the week and so there are now more people, other than the Proprietors family, who are involved in her life and who she may be able to speak to about any problems. 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 still intends to attend training with regard to Safeguarding Adults. This requirement is repeated. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is adequate This judgement has been made using available evidence including a visit to this service. The temporary accommodation meets the clients needs EVIDENCE: The Proprietors permanent Home (the registered address) 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. This causes difficulties for the client in accessing leisure and educational facilities. The Proprietor has been liasing with the Housing department in an attempt to move to a more suitable house in a better location but has been unsuccessful in this. Therefore, the Proprietor and the client moved to temporary accommodation which is located in a small town with shops and other 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 16 amenities close by. The visit was carried out to this address and the client showed the Inspector around some of the communal areas of the house. The Proprietor is aware of the need to make a decision about accommodation as an application for registration will be needed if they are going to remain in this new address. The house has three bedrooms and adequate communal living space. The Proprietor said that she has plans to redecorate the clients bedroom and to replace the carpet in there as there is an unpleasant smell. She also has plans to decorate some of the other rooms in the house. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 17 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. 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 undertakes relevant training. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. 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 client is happy living with the Proprietor and feels that her needs are met EVIDENCE: The client has lived with the Proprietor and her family for over eighteen years, since she was a child. The Proprietor does not have any formal qualifications but is in the process of undertaking NVQ training. In the last year she has attended Food Hygiene training and has plans to attend further relevant training. However, due to the lack of transport provided to enable the client to attend day services the Proprietor finds it difficult to have enough time to attend training. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 19 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 takes steps to protect the health and safety of the client that might be reasonably expected within a normal family home. For example, there are smoke detectors situated around the house. 44 Monks Close DS0000062976.V356275.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 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 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 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 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.V356275.R01.S.doc Version 5.2 Page 21 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) Timescale for action 31/03/08 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.V356275.R01.S.doc Version 5.2 Page 22 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.V356275.R01.S.doc Version 5.2 Page 23 - 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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