Inspection on 05/07/05 for 52 Porthcawl Green

This inspection was carried out on 5th July 2005.

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

52 Porthcawl Green 25/03/09

52 Porthcawl Green 08/01/09

52 Porthcawl Green 22/10/08

52 Porthcawl Green 31/10/07

52 Porthcawl Green 28/12/06

52 Porthcawl Green 04/05/06

52 Porthcawl Green 15/11/05

52 Porthcawl Green 13/07/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 08/07/2008.

CARE HOME ADULTS 18-65 Porthcawl Green (52) Tattenhoe Milton Keynes Bucks MK4 3AL Lead Inspector Gill Gentles Unannounced 05 July 2005 09.45 a.m. The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Porthcawl Green (52) Address Tattenhoe, Milton Keynes, Bucks, MK4 3AL Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01908 506865 The Disabilities Trust Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 11 January 2005 Brief Description of the Service: Porthcawl Green is a home in the community managed by the Disability Trust. The home accommodates three males with Autistic Spectrum Disorders. The house is situated on an estate in Milton Keynes, close to the Westcroft centre where there are several shops and supermarkets. Local transport networks gives access to central Milton Keynes and Bletcheley. There is a main line train station in the city giving access to London and the North. The home has three bedrooms, one en-suite, an office/sleeping in room, a visitors room and a bathroom on the first floor. On the ground floor there is a large lounge, dining room, laundry and kitchen. The home also has a separate office for the Disability Trust for the homes in the area, which does not impact into the running of the home. There is a small garden, mainly laid to lawn with pretty floral boarders. There is ample communal parking at the front of the home for staff cars and visitors. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on Tuesday 5th July 2005 between 9.45 am and 2.30 pm. The first hour of the inspection was spent talking to the three Service Users who live in the home and the staff on duty. The inspection involved talking to the manager, staff, Service Users and meeting the service manager for the autistic services of the Disability Trust. Records were perused and a tour of the communal areas took place. What the service does well: What has improved since the last inspection? What they could do better: Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 6 Produce a Statement of Purpose and Service Users Guide that adequately reflects the current service in the home to ensure prospective Service Users have an informed choice. Produce care plans with Service Users in an appropriate format. Review all risk assessments pertinent to Service Users. Ensure staff are trained in mandatory areas and POVA. Ensure all personnel records comply with Schedules 2 and 4 of the Care Homes Regulations 2001. Ensure that health and safety requirements for residential care homes are complied with. 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. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1,2,5 The homes Statement of Purpose and Service Users Guide are outdated; therefore prospective Service Users do not have the appropriate information to make an informed choice. Detailed contracts, signed and dated are in place, ensuring Service Users and their representatives clearly understand the terms and conditions of living in the home including the weekly fees. EVIDENCE: The home does not have a current Statement of Purpose and Service Users Guide the last one was dated June 03. Through discussion with the new manager it was agreed a timescale of the end of September for completion of both documents. The existing Service Users have lived in the home for some years now so there has been no need for any assessments to be carried out of prospective Service Users. Contracts were in situ and viewed during the inspection. Service contracts were found to have been signed by the Service Users and the previous manager and clearly dated 1.4.05. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 9 Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 9 Care plans were found to be adequate to ensure personal and social care needs were being met, however their was no confirmation that Service Users are involved therefore receiving the care they require. Detailed risk assessments were in place and pertinent to individuals, however a number were out of date, therefore Service Users may not be adequately safeguarded against risk. EVIDENCE: Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 11 All Service Users have a personal file that contains the following information:Fact sheet Medical history Health record Medication Support guidelines “about my disorder and other diagnosis” College information and dates Weekly planner Guidelines for personal care Personal guidelines Communication needs Family and social contact Cultural needs Risk assessments “This is me” Photograph of Service User Things I have achieved Weight chart Daily records Key-worker guidelines, duty list and training Care plan. All information was found to be easy to read and informative, however it was noted that some of the information was dated, not Service User led and written in the third person. The new manager needs to develop the plans with the Service Users in a format suitable to the individuals. There were a number of risk assessments in place for each individual Service User, which were comprehensive. Although a number had been reviewed during the past twelve months, risk assessments such as managing money, washing/ bathing, sharp objects and self harming had not been reviewed since November 03. Some risk assessments need to be reviewed more regularly, which the manager needs to ensure is taking place. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12,13,14,17 Service Users are able to access a wide range of amenities which meet their social, leisure and spiritual needs. Service Users are given ample opportunities to access the local community and amenities and benefit from good staff support. Service Users are able to choose their daily and weekly activities which staff facilitate promoting independence and choice. Service Users are supported to develop the menus and participate in cooking and shopping, which promotes independence and choice and develops independent living skills. EVIDENCE: Throughout the home there are a number of daily and weekly planners displayed by the Service Users, which clearly identify individual daily activities and which member of staff is working with them offering support. Care plans included a list of activities enjoyed by each Service User. Through discussion with all the Service Users it was very clear that they are involved in choosing their daily plan. One Service User told the inspector all Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 13 about his organ playing, writing his music and singing and how he had recently performed in a music afternoon in Wolverton Church. He also reported that he loves to write short stories and words for his music and is also in the process of having a CD made, the manager and staff team are very supportive of these activities. Another Service User was busy having Piano lessons and the third Service User was off to the shops to buy a paper so he was able to select a movie as he was off to the cinema that afternoon. The planners are written by the individual Service Users and activities chosen for the week of the inspection included board games and cards with each other and staff, going to the local shops, out for lunch, Service Users meeting, pub, college, bowling, cooking, cleaning and making a meal. The staff rota is arranged around Service Users needs and one to one time is available throughout the day for all Service Users. A menu is on display in the kitchen on the notice board, which appears to have been written by the Service Users and it clearly identifies who had chosen which meal. Breakfast is generally cereals and toast, except for the weekend when a cooked breakfast is selected. At lunchtime Service Users chose what they want and when they want it. During the inspection one Service User took himself off to McDonalds for lunch. Evening meals are chosen by the three men and appear to be nutritiously balanced. There is no fixed time for eating meals, each day is worked around the activities being carried out. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) These standards were not assessed during this inspection. EVIDENCE: Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22,23 The home does not have a clear complaints system in place to ensure that Service Users are being listened to. Vulnerable adults are protected with the appropriate policies and procedures being in place, however, staff have not been trained therefore putting Service Users at risk from abuse. EVIDENCE: The home has not recorded receiving any complaints since the previous inspection in January 05. However, a report from the neighbours had been made to the local police and was handled appropriately by the care staff. The Commission for Social Care Inspection area office received a complaint, which was passed back to the organisation to investigate and resolved, an outcome was forwarded to Commission for Social Care Inspection. The home has a policy in place relating to the protection of vulnerable adults, however there were no records to confirm that staff have received the relevant training in line with Milton Keynes multi-agency guidelines and procedures. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 Porthcawl Green is nicely decorated, clean, neat and tidy, protecting the health and welfare of the Service Users. EVIDENCE: There have been no structural changes made to the home since the last inspection in January 05. Porthcawl green is a detached house situated on an estate in Milton Keynes, close to local amenities and within easy distance of the bus routes to the centre of Milton Keynes. All service users have their own bedrooms one with an en-suite. Communal areas consist of on the ground floor a lounge, a dining room, utility room and kitchen. On the first floor there is a small quiet/visitors room, three single bedrooms, a sleep in/office and a bathroom. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 17 The home is nicely decorated offering a homely ambience. The home was warm with adequate lighting of a domestic nature. There were no offensive odours apparent in the home and ventilation appeared to be adequate. Furnishings are all of a domestic type and appear to be of good quality. Radiators do not have low surface covers; risk assessments are in place identifying that there is not a need for them, however the risk assessment should be reviewed regularly. The inspector toured the communal areas and found them to be very clean and tidy, nicely decorated with no maintenance work being identified. The home did however have a door wedge propping open the kitchen door, the manager was informed that it is an offence to wedge open fire doors especially kitchen ones. The wedge was immediately removed and all staff on duty told not to hold fire doors open with any objects. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,33,34,35,36. Adequate levels of staff were available who clearly have an understanding of their roles and responsibilities and are able to provide the appropriate care to meet Service Users current needs. Personnel records were difficult to track and items were found to be missing therefore it was difficult to ascertain that Service Users are appropriately safeguarded from abuse. There are poor training records in place; those that are, clearly identify a shortfall in the mandatory training, which is a potential hazard for Service Users. All staff are now receiving one to one supervision from the new manager, ensuring that the Service Users are receiving care from staff who are being given clear direction and guideance. EVIDENCE: Through observation and talking to staff it was clear that they understand their roles and responsibilities. There were no Job Descriptions held in the staff personnel records, which does not mean that they do not have copies of their job descriptions. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 19 Personnel records have only recently been given to the manager, as they were maintained in the Disability Trust’s office. The new manager has not had the time to analyse the files as she has only been in post for two weeks. Two files were perused and it was found to be difficult to track all that is required. The files were in a muddle with information such as application forms, interview outcomes, authenticated references and last employer references not being in place. It was discussed with the manager that the personnel records need to be re-organised and to produce a matrix in line with schedule 2, to help identify the shortfalls. The home has 4.5 whole time equivalent staff in post with one full time vacancy, plus the new manager. The home also utilise the services of Bank staff employed by the organisation. The rota clearly identified that staff are deployed to meet individual Service Users needs. Training records were analysed and found to be difficult to follow. There were a number of shortfalls in some areas in particular the mandatory training. Records showed that the home has one First Aider, three with Food Hygiene certificates, one with Manual Handling, everybody with Fire Awareness, three with Medication training none trained in POVA or Health and Safety. An immediate requirement was issued in relation to First Aid and POVA training being accessed by the 2.8.05 and the other shortfalls areas by 15.9.05. It was noted that although the new manager has only been in place for two weeks she has already instigated supervision sessions for all the staff team. Records identified that staff members had received regular supervision from the previous manager where subjects such as the key worker role being discussed. It is strongly recommended that the manager improve the storage of the supervision records as they were found to be mixed with all the personnel information and difficult to track. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 Certificates were not available to provide confirmation that the Service Users are living in a safe environment. EVIDENCE: Health and safety records were observed, all fire checks are carried out appropriately at the prescribed times. Annual service records were in place and there were no requirements. The only area to improve in relation to fire was the use of a door wedge, which is mentioned earlier in the report. The certificates for Gas, Electricity and Water Chlorination were requested, but the manager was unable to locate them. It was requested that the manager forward copies to the local Commission for Social Care Inspection office as soon as she has located them. Copies of the certificates arrived at the Commission for Social Care Inspection’s area office on July 20th 05. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 2 x x x 3 Standard No 22 23 ENVIRONMENT Score 2 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 x x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x x x x x Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 x 2 2 1 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Porthcawl Green (52) Score x x x x Standard No 37 38 39 40 41 42 43 Score x x x x x 2 x 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 22 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. 1. Standard 1 Regulation 4(1) 5(1) Requirement The manager is required to produce a current Statement of Purpose and Service Users Guide and forward a copy to the Commisssion. The manager is required to produce the care plans in a format suitable to Service Users and with their involvement. The manager is required to review all risk assessments pertiinent to Service Users. The manager is required to ensure that the Service Users know and understand the procedure for making a complaint, and that they have information relating to the Commission. The manager is required to ensure that all staff receive training in relation to Adult Abuse Awareness and confirmation be forwarded to the Commission. The manager is required to ensure that personnel records are re-organised and easy to access. A staff mattrix is to be forwarded to the Commission identifing the records held and Timescale for action 5.9.05 2. 6 15 31.10.05 3. 4. 9 22 13(4) 22 15.9.05 1.9.05 5. 23 18(1) 2.8.05 6. 34 19(1) 20.8.05 Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 23 missing from Schedule 2. 7. 35 18(1) The manager must ensure that all staff receive the required mandatory training annually or three yearly as required. The manager is required to ensure that all gas, electical and water chlorination checks have been completed and copies of the certificates be forwarded to the Commission. 15.9.05 8. 42 13(3-6) 15.8.05 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 36 Good Practice Recommendations It is recommended that the supervision records be held with the personnel records and training records to aid access. Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 24 Commission for Social Care Inspection Cambridge House, 8 Bell Business Park, Smeaton Close, Aylesbury, Bucks, HP19 8JR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Porthcawl Green (52) 050705_Porthcawl Green (52)_UI_Stage 4_S30990_V230639_H53_GG_ces.doc Version 1.30 Page 25 - 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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