Inspection on 12/09/07 for Apple House

This inspection was carried out on 12th September 2007.

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 10/05/06

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 Tobias Payne Key Unannounced Inspection 12th September 2007 3:00 Apple House DS0000001657.V341509.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 Apple House DS0000001657.V341509.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. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 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.V341509.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration. Date of last inspection 10th May 2006 Brief Description of the Service: Apple House is a small care home providing personal care for people with learning disabilities in the Wigston area of the City of Leicester. All residents have their own bedrooms, which are personalised and homely. There is a kitchen and dining room and a separate lounge. Residents also have access to the back garden. All residents attend outside work during weekdays and enjoy these activities. The fees at the inspection on the 12/9/2007 ranged from £337 to £340 each week. There are additional costs for individual expenditure such as hairdressing, toiletries, holidays etc. Information about the home including the statement of purpose and the service user’s guide can be obtained from the manager. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection visit was unannounced and started at 3.00 pm. It was undertaken using a review of all the information available to us about Apple House Care Home. We spoke with 5 residents, 2 members of staff and the manager. The main method of inspection was called “case tracking”. This involved selecting 2 residents and tracking the care they received through the checking of records, discussion with them, the care staff and observation of their care. We also received 8 comment cards from each resident and an Annual Quality Assurance Assessment completed by the home. What the service does well: 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. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 6 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.V341509.R01.S.doc Version 5.2 Page 7 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): 1, 2 and 3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents living at the home receive sufficient up to date information to enable them or their relatives/advocates to make an informed choice as to whether or not they wish to live in this home. Apple House met the needs of residents coming into the home. EVIDENCE: There was a statement of purpose and service user’s guide. There remains an established group of residents. No new resident had been admitted to the home since the last inspection. The manager explained that if there was a referral the resident would be assessed and information obtained in order to obtain as much information as possible about the resident. If they could meet the resident’s needs then written confirmation would be sent to confirm the home was able to meet their needs. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 8 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): Standards 6, 7 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were care plans to show staff how to meet the residents’ needs. The health and welfare of the residents was therefore fully met. Residents are encouraged to make decisions for themselves and be independent with the support and guidance of staff. EVIDENCE: Each resident had a care plan. The care plans included essential information about the resident, their likes and dislikes, assessed needs, agreed action/goals covering all aspects of daily, health care needs, personal care needs, interests, safety, medical care and support. There was evidence of review dates and the care plan was reviewed monthly. There were clear records of significant events in each resident’s life. Where required it contained a risk assessment, daily record, independent living skills, medication directions and health action plans. Care plans were person centred, factual and dated with a clear audit trail of significant events. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 9 Residents independence was encouraged and they cleaned with support where identified their own bedrooms, helped in the kitchen, did their own ironing and prepared their packed lunches for the next day. Residents commented “we can do what we want to do”, “I can get up when I want to do when I don’t go to work”, and “there are not many rules”, “I look after my medicines and my money and if I need any help I can talk to the staff”. Choice and decision making was clearly shown in the care plans and staff were trained to enable these choices to take place. Residents were given choice concerning their interests and activities. We saw staff responding to the residents in a positive manner. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 10 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): Standards 12, 13, 14, 16 and 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents were involved in meaningful and appropriate activities, which included work, educational and recreational activities. This enabled them to lead an independent life free from institutional rules. EVIDENCE: During the day residents went either work or to local day centres from 09.00 to 15.30 hours Monday to Friday. On return there was a programme of evening activities, which were flexible and had been arranged following discussions with the residents. These activities were varied and could include as it did on the day of the inspection visit a visit to the local British legion Club in the evening. Other activities included swimming, clubs, eating out and visits to the cinema. A number also attended local educational colleges. They also visited the local Gateway club. As the inspection visit took place when they had returned from the their day at work, residents were watching television in the lounge or in their bedrooms. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 11 One was helping preparing the evening meal with a support worker. Others were spending time in their bedrooms before tea. There was a relaxed and friendly atmosphere. Residents said they could make decisions about their own lives and what time they wished to go to bed. Each person had information in their care records about contact with family and friends and their preferred activities. The kitchen was clean and tidy with a first aid box. The last Environmental Health Officer’s inspection was on the 5/10/2005 by Oadby and Wigston Borough Council. There were no concerns. Records were being kept of food provided. This showed that an alternative was available if they did not want the main choice. There was evidence of fresh fruit and vegetables being available. Residents commented “we went to Blackpool recently. I liked the hotel and looking in the shops”, “I went to Skegness the other day and went on the beach” and “I like playing pool and going into town”. Others spoke of going to jumble sales, going out for the day and going to the local church. They also said they enjoyed the food. As there is an established community of residents formal meetings only take place when there are any issues. The residents felt they could discus anything with the staff and the manager. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 12 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): Standards 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and emotional needs were met. Resident’s needs were monitored regularly. Staff gave support to the people living in this home. EVIDENCE: Residents told us they needed no physical assistance and remained independent. There was community nurse involvement and each person was registered with local GPs. There were no major healthcare issues. Several residents were Diabetic but they were well monitored by the home and the Diabetic nurse. There were clear records of any medical intervention. Residents said that if they were unwell they would tell the staff and they would get a GP to see them. Each resident had been assessed as able to self medicate and there were safe arrangements in the home. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 13 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): Standards 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Any complaints received are taken seriously and residents are protected from abuse. People feel that their views are listened to. EVIDENCE: We and the home had received no complaints since the last inspection. There was an adult protection policy and all staff as part of their induction received abuse training. The local adult protection policy was also available. Staff were to receive a refresher adult protection training programme in the near future. The member of staff present knew about abuse and what they would do if abuse was suspected. Residents commented, “I am very happy here, the staff are good and if I have any worries I can discuss it with them”. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 14 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): Standards 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents live in a safe, clean, homely and comfortable accommodation, which reflected their individuality. EVIDENCE: The home was clean, comfortable and odour free throughout. Residents spoke about how much they liked their bedrooms and living in the home. An audit of the environment took place in January 2007. As a result of this a number of maintenance issues had been addressed, windows painted and a new bed was on order for one of the residents. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 15 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): Standards 32, 34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There were safe levels of staff and staff knew how to meet the residents’ needs. EVIDENCE: There were no staff vacancies. The home was staffed by 2 people when the residents were in the building and at night there was one sleep in member of staff. During the day when there are no residents in the house there were no staff. However staff were able to be contacted by mobile phone if a resident needed advice or support. There were 4 staff including the manager. There were 2 staff who had obtained National Vocational Qualifications level 2 and the manager had obtained NVQ level 3. Training had included, first aid, person centred planning, communication and health facilitation. A new member of staff had been recruited with an application form, 2 references and a Criminal Records Bureau check and a supported induction. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 16 The staff felt they could meet the needs of the residents and felt they had sufficient time. This was observed during the inspection by staff laughing, talking with and joking with the residents. Staff also spoke of the support provided and how they all worked as one team. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 17 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): Standards 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff are lead by an experienced, competent and committed manager who supported the staff and residents. Residents’ benefit from a well run home. EVIDENCE: Residents spoke of “living in a happy, friendly and well run home”. They were complimentary about the staff and manager. There was a very relaxed and happy atmosphere in the home and staff showed knowledge about the needs of the residents. A survey of residents was carried out in December 2006 and 90 of forms had been returned showing that 100 were happy or felt the home was okay. This was echoed by the results of our survey which also showed residents were happy. It was summed up by a comment “I do not think they could improve on anything they are already doing. They are doing well”. There had also Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 18 been a contract monitoring visit made by Leicester City Council in May 2007. There were no concerns. There was no staff or residents from outside the UK and staff knew how to support each resident to lead an independent life. There were no equality and diversity issues. The manager was aware of the Mental Capacity Act 2005. Records examined on the day of the inspection were available, well maintained and up to date. The home had a health and safety policy together with detailed risk assessments covering all aspects of daily living activities. A detailed fire risk assessment had also been carried out. There were regular tests of the fire system as well as regular fire drills. Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 19 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 3 2 3 3 3 4 X 5 X 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 3 x LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 X 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.V341509.R01.S.doc Version 5.2 Page 20 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. Refer to Standard Good Practice Recommendations Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 21 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln Ln6 3QN 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 Apple House DS0000001657.V341509.R01.S.doc Version 5.2 Page 22 - 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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