Inspection on 18/12/08 for 5 Beacon Gardens

This inspection was carried out on 18th December 2008.

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 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

5 Beacon Gardens 19/06/07

5 Beacon Gardens 24/02/06

5 Beacon Gardens 23/08/05

5 Beacon Gardens 23/02/05

5 Beacon Gardens 31/03/04

Similar services:

Polesworth Group Friary Road

Polesworth Group Pooley Heights

Polesworth Group 32 Station Road

Polesworth Group 70 Long Street

Breme

Polesworth Group 64 Long Street

Polesworth Group 68 Long Street

10 Whitfield Avenue

Extracts from inspection reports are licensed from CQC, this page was updated on 12/03/2009.

CARE HOME ADULTS 18-65 5 Beacon Gardens Beacon Street Lichfield Staffordshire WS13 7BQ Lead Inspector Wendy Jones Unannounced Inspection 18th December 2008 15:00 5 Beacon Gardens DS0000005074.V373777.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 5 Beacon Gardens DS0000005074.V373777.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. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service 5 Beacon Gardens Address Beacon Street Lichfield Staffordshire WS13 7BQ 01543 264720 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Margaret Jean Holton Provider in day to day control Care Home 1 Category(ies) of Learning disability (1) registration, with number of places 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home Only (Code PC) To service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: 2. Learning disability (LD) 1 The maximum number of service users who can be accommodated is: 1 19th June 2007 Date of last inspection Brief Description of the Service: 5 Beacon Gardens is a family home, which was once registered to provide care for two people with a learning disability. It has since been reviewed and is only registered for one person. This is the choice of the provider. The home is a semi-detached property situated in a cul-de-sac on the outskirts of Lichfield town centre. The cul-de-sac is found off a main road leading into Lichfield, and there is easy access to a large supermarket at the bottom of the road. Access to public transport is also very close by, with regular buses into Lichfield town and all of its amenities. The person living in this home has been with the family from the age of two and a half years. In that time he has been treated as a family member with the proprietor acting in loco parentis with the extended family as substitute aunts and uncles. The provider should be contacted for information about the fees charged at the service. No additional charges are made. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 1 star. This means the person who uses this service experience adequate quality outcomes. This was a key inspection site visit of this service undertaken on 18 December 2008. In total it took approximately 3 hours. The purpose of this visit was to assess the services performance against the National Minimum Standards for care homes, and to establish if it provides positive outcomes for the person who lives there. We also checked to see if any of the recommendations made at the last key visit of 18 June 2007 have been acted upon. We have been provided with an Annual Quality Assurance Assessment (AQAA) which is the service’s own assessment of its performance. This provided us with limited information about the service that is offered. We have sent out surveys to the service for the person who lives there and for distribution to other people such as the GP, social worker, health professional and any other person involved in the life of the person using the service, but we have not received any completed surveys. We spoke to a social worker and confirmed that the provider Mrs Holton provides a good standard of care. We talked to the person who uses the service who said, “I like living here, this is my home and I want to stay here.” We made three recommendations as a result of this visit, Mrs Holton has confirmed since then that she now has the new local Safeguarding Procedures and records when the fire alarm is checked. What the service does well: This service is unusual in that it provides for a young adult who has resided there since he was an infant. In this respect it presents an ideal opportunity for him to live as part of a family in an ordinary house in the community. The home is not distinguishable from any of the other houses in the area. The home is maintained to a high standard throughout. Mrs Holton promotes the person’s rights to be independent and supports him to access a wide range of lifestyle opportunities. He is involved in day-to-day decision-making and makes real choices about what he wants to do. He is a valued member of the community. Mrs Holton ensures that the person using the service has his health needs met, by promptly seeking advice when problems occur and supporting him to attend appointments. Regular health checks are recorded and he is able to selfadminister his medication. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 6 The person using the service is confident that if he has any concerns that he will be listened to and has access to an independent advocate if he needs to be supported. He said, “Mum will sort out any problems she helps me with things like that.” Mrs Holton understands her responsibilities in protecting the person using the service from abuse. Of the eight recommendations from the last inspection visit Mrs Holton has acted on three of them. 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. 5 Beacon Gardens DS0000005074.V373777.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 5 Beacon Gardens DS0000005074.V373777.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 (good) This judgement has been made using available evidence including a visit to this service. The person using the services needs have been satisfactorily met and the promotion of independence has ensured that he enjoys a good quality lifestyle. EVIDENCE: The provider has not produced a Statement of Purpose or a Service User Guide. This is because she does not intend to offer a service to any one else. Mrs Holton stated that the fees that are paid to the provider are in line with the funding authority standard rate. The person using the service has lived at the home since he was an infant, originally receiving foster care but remained living as a member of the family once reaching adulthood. We spoke to him on his own during the visit and established that he is quite firm in his views that he is happy living with the provider who he calls mum. We spoke to the social worker and confirmed that the placing authority continue to be satisfied with the service, they maintain that the provider supports the person using the service to be independent and adheres to the terms and conditions of the contract they have with her. 5 Beacon Gardens DS0000005074.V373777.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): Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. The person using the service can be confident that his care needs are known and met as determined by the care plan in place. But records are not maintained to a minimum standard. EVIDENCE: As discussed at previous inspection visits, Mrs Holton has a copy of the local authority placing officers care plan to adhere to, but has not produced any other documentation from this, for example support plans. Regular annual reviews of care are undertaken by the local authority to ensure that the care plan remains relevant and the person using the service can be sure that his needs are met. He is included in these reviews and the social worker confirmed that she speaks to him on his own when she visits. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 10 Mrs Holton does record significant events in the individuals’ life such as health appointments and areas of concern in a notebook. But there is no evidence that support plans are evaluated regularly. Mrs Holton discussed risk assessment and the action she has taken to minimise the potential risk to the person using the service since he has suffered some health difficulties. She has recorded the action taken and discussed it with the individual and his social worker. The person using the service has his personal allowance from Mrs Holton, he also receives a lower rate mobility allowance. 5 Beacon Gardens DS0000005074.V373777.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): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. EVIDENCE: The person using the service accesses college on Monday, attending computer, literacy, and road safety awareness courses. Until quite recently he was employed at a local supermarket on Tuesday each week, but concerns about his health have meant that he can no longer work safely there and is currently not at work. Both he and Mrs Holton are anxious that when a diagnosis is made and hopefully treatment prescribed that he should once again be able to find employment. He continues to do some voluntary work at the local Methodist centre on Wednesdays. Thursday is a day where the person using the service stays at home. Fridays are usually the family shopping day and at weekends he and the provider either visit family and friends or go out with them. Mrs Holton stated that the person using the service has a number of friends in the local 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 12 community and does go out with them usually, but concerns about his health have limited some of these activities. Holidays are usually spent in Wales where Mrs Holton has relatives. The nature of the service operating as a family home means that Mrs Holton takes responsibility for the bulk of the domestic and catering chores, but the person using the service assists with these. They usually decide together what meals they want to have. Mrs Holton also explained that there are some special dietary requirements that need to be adhered to. At the last inspection visit we talked to Mrs Holton about the person using the service’s future and promoting his independence further. Since then he has spoken to his social worker and outlined what he wants to do in the future. The social worker is in the process of putting plans in to place to ensure that his wishes are carried out. 5 Beacon Gardens DS0000005074.V373777.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): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The person using the service can be confident that his personal and healthcare needs are met. EVIDENCE: The provider told us in the AQAA that health checks are carried out regularly and any special needs are provided for. We saw evidence that the person using the service is supported to receive and attend health appointments on a regular basis, including chiropody, ophthalmic, auditory, GP and hospital appointments. The person using the service has hearing difficulties and uses a hearing aid, but is able to communicate effectively. Currently Mrs Holton does not need to deliver personal care, as the person using the service is independent in this area. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 14 The social worker confirmed that Mrs Holton keeps them informed of any problems or concerns. Currently some health issues have arisen that are under investigation by specialists at the local hospital. Mrs Holton gave an account of how she has changed her risk assessment and monitors the person living at the home more closely at times and in situations where he could be vulnerable and at risk because of his current health state. In respect of medication, the person using the service manages this with support from the provider. He collects his own prescription from the pharmacist, and self-administers his medication. Mrs Holton does not have a policy or procedure in relation to medication, as she doesn’t feel the need to have one, the evidence of this visit indicates that despite this medication is managed appropriately. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is (good) This judgement has been made using available evidence including a visit to this service. The person using the service can be confident that the provider understands her responsibilities to protect him against the risk of abuse, and he can be sure that if he has any concerns about any aspect of his care he will be listened to. EVIDENCE: We have not received any complaints about this service and are not aware of any safeguarding issues. We spoke to the person using the service who confirmed that he does not have any concerns about the service he receives. He said he can talk to Mrs Holton about any problems and also has a MENCAP advocate he meets with regularly whom he feels he can talk to. Mrs Holton has said in the AQAA that she hasn’t received any complaints and says that she promotes the person using the service’s rights. She also says in the AQAA that she has bought up the person using the service to respect other cultures and to treat others with respect. At previous inspections we have discussed the lack of proper policies and procedures and asked that Mrs Holton access a copy of the Local Safeguarding procedures that are available in Staffordshire. This will ensure she and the person using the service have up to date information about who to contact in the event of alleged or suspected abuse. To date she has not done this. In discussion with Mrs Holton it is clear that she understands her responsibilities 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 16 to safeguard the person she provides care to and demonstrated a willingness to advocate on his behalf. The social worker has confirmed that safeguarding is discussed in the annual reviews that are undertaken with the person using the service. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 17 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): Quality in this outcome area is (excellent) This judgement has been made using available evidence including a visit to this service. The quality of the accommodation is high providing the person who lives there with a safe, clean and comfortable home in which to live. EVIDENCE: The service is a family home, which is located in residential area of Lichfield. It is a semi-detached property in a cul-de-sac and not distinguishable from other properties as a care home. All furnishings and fittings are of good quality and present a homely appearance. From observation it was clear that the person living at the home is comfortable and secure in his surroundings. The accommodation provides sufficient personal and communal space to meet the needs of the person living at the home and the provider. There is a comfortable lounge room, a spacious kitchen of domestic style and design, a conservatory area and toilet on the ground floor. On the first floor the person 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 18 living at the home has the use of two bedrooms; both are well maintained and pleasantly decorated. We saw that the person using the service was able to arrange his rooms as he chooses. One is equipped with a television, DVD player, CD player and a laptop computer and bedroom furniture. In addition to the providers’ private room, the first floor has a bathroom and wc. All areas of the home are accessible to the person living there; we noted that there are no concerns regarding the cleanliness of the service and no infection control issues. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 19 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 (good) This judgement has been made using available evidence including a visit to this service. The person living at the home has 1:1 support from the provider when he is in the home, which ensures that his needs can be easily met. EVIDENCE: The provider does not employ any staff and is the sole registered provider and manager. She has been in the care industry for a long time, previously working in older persons services and care homes for people with learning disabilities. She has provided care and accommodation for the person living at the home since he was an infant. The service is operated as a family home with the person living there a member of the family. Mrs Holton has not undertaken any recent training and does not employ anyone else. Because she doesn’t employ anyone else there are no recruitment records to inspect. Mrs Holton relies on her family to offer support when needed and we talked about the close relationships the person using the service has with Mrs Holton’s daughters. We have also been told that neighbours are available to offer support in the event of an emergency. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 20 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 21 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): Quality in this outcome area is (adequate) This judgement has been made using available evidence including a visit to this service. The person living at the home can be confident that the provider manages the service in his best interests, but cannot be confident that she is up to date with current procedures this has the potential to place him at risk. EVIDENCE: We have received an AQAA for the service. It contains limited information about the home and doesn’t provide enough detail to make a judgement about the quality of care provided or how the service intends to continually improve. Mrs Holton has been involved in care for over 40 years and has provided care and accommodation to the person living with her since he was a infant, initially as a foster carer and then deciding to register the service as a care home when 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 22 he reached adulthood, to ensure his care needs could continue to be met. She has not undertaken any of the training recommended for managers of care settings and also has not recently undertaken any training at all. She does have her care and life experience to draw on but should ensure that she is up to date with current trends and procedures. We have previously discussed the need to obtain current safeguarding procedures to ensure that Mrs Holton knows whom to contact and what to do in the event of suspected or alleged abuse, and the person living at the home should also have access to this information. Mrs Holton is aware of the need for risk assessment and understands the principles of it although record keeping is limited. In terms of quality assurance Mrs Holton doesn’t have a formal system to assess and monitor the quality of the service she provides. The social worker that reviews the placement has confirmed that she is satisfied that the service provided meets the care needs of the person living at the home. She, Mrs Holton and the person using the service have discussed future care provision, having listened to the views of person living at the home. They are putting into place plans to ensure that his future is secure and in keeping with what he say he wants to do and where he wants to live. Mrs Holton has said that servicing of equipment in the home is up to date, and there is current buildings and contents insurance. The certificate of registration is on display. We spoke to the person using the service about what he should do if the fire alarm goes off and he gave an account of the evacuation procedure for the home. 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 23 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 1 2 3 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 4 25 4 26 x 27 x 28 4 29 x 30 4 STAFFING Standard No Score 31 x 32 x 33 x 34 x 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 x 2 x 2 x x 2 x 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 24 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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 YA23 Good Practice Recommendations It is recommended that the registered manager obtain a copy of the Local Authoritys policy and guidance on The Vulnerable Adult Procedure. Mrs Holton should consider recording when she checks that the fire alarm is operating properly. Mrs Holton should ensure that she is up to date with current practice. 2. 3. YA42 YA31 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection West Midlands West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT 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 5 Beacon Gardens DS0000005074.V373777.R01.S.doc Version 5.2 Page 26 - 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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