Inspection on 10/05/06 for Apple House

This inspection was carried out on 10th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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

Apple House 12/09/07

Apple House 21/12/05

Apple House 03/08/05

Apple House 31/01/05

Apple House 16/08/04

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Apple House 16/22 Bushloe End Wigston Leicestershire LE18 2BA Lead Inspector Keith Charlton Unannounced Inspection 10th May 2006 03:40 Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Apple House Address 16/22 Bushloe End Wigston Leicestershire LE18 2BA 0116 288 8028 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) Ms Joanne Archbold Ms Joanne Archbold Care Home 8 Category(ies) of Learning disability (8) registration, with number of places Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 21/12/2005 Brief Description of the Service: This is a small residential home for people with learning disabilities in the Wigston area of the City. All service users have their own bedrooms, which are personalised and homely. There is a kitchen and dining room and a separate lounge. Service users have access to the back garden. All service users attend outside work during weekdays and enjoy these activities. The maximum weekly fee is £332, this information was provided on the day of the Inspection. There are additional costs for individual expenditure such as hairdressing, toiletries, holidays etc. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting two service users and tracking the care they received through looking at their records, discussion, where possible, with them and care staff and observation of care practices. This was an unannounced Inspection. The Registered Provider, the Deputy Manager and one staff were present on the first inspection day. The Registered Provider and the Deputy Manager were on duty to assist with the inspection process for the second inspection day on 11/5/06. Planning for the Inspection included checking on any notifications of significant events sent to the Commission for Social Care Inspection by the home and referring to the last Inspection Report. There have been no complaints received by the Commission for Social Care Inspection regarding any concerns in the past year. The Inspections took place between 15.40 and 19.05 on the first day and 10.00 and 11.40 on the second day and included a selected tour of the building, inspection of records and indirect observation of care practices. The Inspector spoke with six residents, two members of staff and the Registered Provider. What the service does well: Service users were all again very satisfied with all aspects of living in the home and thought all their needs were covered. They thought their opinions were listened to and if they ever had a complaint it would be properly looked into by staff – they specifically said they liked all their outside activities, how they are treated by staff, the food that is provided was very good, there was a lack of rules and they were free to have their bedrooms arranged in the way they wanted. The manager and staff demonstrated good relationships with service users living at the home, and have a good understanding of the individual needs of each client. Reviews conducted by the Social Service Departments again confirmed that this is the case. The philosophy of the service is to ensure that service users can live independently as possible, for example service users self medicate, deal with their own finances, can travel independently, and there are many recreational and educational activities. Service users recently interviewed a prospective staff member as to whether they thought she was suitable to work in the home. Good, up to date records are kept at the home, that clearly demonstrates the needs of each client and how staff at the home provide support as needed. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 the following standard(s): 2 Service users needs are properly assessed prior to admission. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users living in the service have been resident for a number of years and there have consequently been no new admissions for a considerable period. There was assessment information on file from Social Service Departments. Service users could not recall these assessments as it was a long time ago. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The individual needs and choices of service users living in the home are well met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 10 Service users could not recall having a Care Plan though when these were checked it was found they had signed them. The Registered Manager said she would remind service users about them, if they wanted to see them, and this was also routinely done at review meetings. Service users said that they were happy to be living in the home and thought that all their needs were catered for in that they could choose how they live their lives and did not feel hampered by any rules. No one could think of any rules and said they could get up and go to bed when they wanted, they took their own medication, they handled their own money etc. The inspector read two clients care records. This again demonstrated that their needs are being monitored and supported with medical appointments made as needed. Records, observations and discussions with service users demonstrated that service users make decisions about their lives and have independent life styles. Each service user has a comprehensive individual plan, which sets out all aspects of the care to be provided by the home - they covered all essential requirements in relation to medication and physical condition, hobbies, occupation, risk assessments, religious belief etc., and they were regularly reviewed. Service users independence is encouraged – e.g. they clean their own bedrooms, wash and dry dishes, go out when they like with support if needed, they were seen to do their own ironing and make up their pack lunches for the next day. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Service users have an independent lifestyle, which is free from institutional rules. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 12 Clients informed the inspector of clubs and classes they are involved in and they were observed to be living independently at the home during the inspection, coming and going from the building, ironing, preparing food, independently having a shower when they came in from their day care activities etc. Records showed that clients have been on trips and on holiday. Service users said that they can have their friends and family members to visit them and the visitors book indicated this. Records, observations and discussions with service users demonstrate that they can make decisions about their lives and have independent life styles if at all possible. Service users talked about going to the shops and to jumble sales. They said they went to the bank to get their money as they all handled their own money. A service user was seen to have come back fro the bank with his bank book after withdrawing money. Staff said service users can make decisions about their own lives e.g. what time to get up and go to bed, to clean their own bedrooms, to help out in domestic chores if they wish. Some service users said they went to the local church. Service users said that they liked the food and the tea meal was observed which they said they enjoyed. Food records were available and showed choices of meals if they did not want the main choice. The Registered Manager tries to ensure that service users have a nutritious meal with fresh vegetables and fruit served though acknowledges that service users have a sweet tooth and buy sweets etc when they are away from the home. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Clients receive good personal support with their physical and emotional health needs being well met. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said that they did not need any physical assistance. The Registered Manager and staff said that service users are encouraged to live independent lives. Through observation, discussion and records, it was demonstrated that clients receive support in the way they prefer and require it. They said that if they had a problem and wanted to talk about it then staff would spend time with them. Service users said if they were ill then staff would get a GP to see them. Two of the clients case tracked, had evidence of health checks carried out and planned for the future. Service users said that they keep their own medication. Medication records were seen to support this and indicate that service users should be asked if they had taken their medication. Medication was found in locked bedrooms, securely kept. There was evidence of the local pharmacist providing training for staff. The Registered Manager was asked to check with the GP as to what Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 14 action staff should take if the urine test for a service user with diabetes was either of a high or low level. This is then to be recorded in the Care Plan. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 the following standard(s): 22,23 Service users feel confident that their concerns would be taken seriously and staff understand the adult protection procedure. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users again said that if they had a problem they would speak to the staff and it would get sorted out. They were confident that this would always happen but everyone said they never needed to make complaints. The Registered Manager said that since the home opened there had never been a complaint from service users but that a complaints book would be obtained if this were ever to occur. The Commission for Social Care Inspection has not received a complaint about the service in the last twelve months. There is a Complaints Procedure in place if service users wish to complain. A staff member was asked as to the whistle blowing procedure and he related this correctly and in full. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 the following standard(s): 24,30 Service users live in a homely environment with their personal possessions accommodated in their bedrooms. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said that they were happy with their bedrooms and with the home in general. There was one comment that the ground floor shower floor tiles were cold to stand on. The Registered Manager said a bath mat would be obtained to deal with this. Some items of furniture and some décor are beginning to look dated, e.g. some easy chairs though the Quality Assurance survey undertaken by the Registered Manager showed that service users were content with facilities. Service users bedrooms were generally clean and odour free and organised in a way that is preferred by them. The Registered Manager said there was an ongoing maintenance programme. A number of windows were being painted at the time of the inspection. Redecoration of some bedrooms is planned for the coming year. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Staff systems are in place to cover the needs of service users. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home generally meets the minimum staffing levels as per the guidelines of the previous registration authority in that there are two staff on duty when there are service users in the service and one sleep in person on duty at night. There are no staff in the service on weekdays when there are no service users on the premises. Staff are contactable through mobile phones in the event of service users needing their support. Staffing records show that the Registered Manager organises detailed checks for new staff prior to employment commencing. The Registered Manager has considered but not implemented the action needed to take to ensure that 50 of care staff achieve a care National Vocational Qualification 2. She feels that staff undertaking the relevant induction and foundation training relating to the service user group is sufficient to meet service users needs. Other training was documented in training records. The Registered Provider is a registered nurse and does not feel that if she undertook a National Vocational Qualification level 4 Management course this would improve the quality of life for service users. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 18 A local pharmacist has supplied medication training. There has also been Person Centred Planning training – a system that identifies service users specific individual needs, and moving and handling training. Future training includes first aid, health facilitation, more Person Centred Planning and communication training. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Service user s benefit from a well run home. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Service users said they live in a well run home and thought the Registered Manager and staff are doing a very good job. There was a Quality Assurance survey carried out in December 2005, which showed that service users who completed the survey were fully satisfied with all the services – staff, food, support, facilities etc. There were records of service user meetings where people are given the opportunity of giving their views on the running of the service and also records of staff meetings documenting relevant issues. The Registered Provider has a Health and Safety folder with Risk Assessments on safe working practices. Fire checks were found to be up to date. The Registered Manager is to again review the fire risk assessment to ensure that it is still fully relevant. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 20 Service users bedrooms are checked to try to ensure that obstacles of personal possessions are not in place. Service users have been assessed as not being at risk from hot water temperatures and uncovered radiators. The Registered Manager said that a company had been employed to carry out a legionella water check but said that as there was a domestic water system this would not difficult to carry out and it was not needed. The Registered Manager was asked to check this issue with the Environmental Health Department to ensure full safety for this issue. Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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 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 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard Good Practice Recommendations Apple House DS0000001657.V294002.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Leicester Office The Pavilions, 5 Smith Way Grove Park Enderby Leicester LE19 1SX 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 Apple House DS0000001657.V294002.R01.S.doc Version 5.1 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!