CARE HOME ADULTS 18-65
Applegarth 1 Rutland Close Leicester Forest East Leicestershire LE3 3PN Lead Inspector
Chris Wroe Unannounced Inspection 6th February 2007 11:30 Applegarth DS0000001826.V327503.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 Applegarth DS0000001826.V327503.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. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Applegarth Address 1 Rutland Close Leicester Forest East Leicestershire LE3 3PN 0116 2395392 0116 2395392 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) www.vistablind.org.uk VISTA Mrs Gaynor Earle Care Home 6 Category(ies) of Learning disability (6), Sensory impairment (6) registration, with number of places Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No person falling within category LD may be admitted to the home unless that person also falls within the category SI - ie dual disability. 26th October 2005 Date of last inspection Brief Description of the Service: Applegarth is a residential care home providing care for up to 6 people. It is registered to provide care for people who need care because of visual impairment, who also have a learning disability. Applegarth is a comfortable home for the individuals who live in it. All rooms are single with en-suite showers and toilets, and individuals have been able to choose the colour of their rooms. All bedrooms are on the ground floor, and there is a large lounge/dining room, kitchen and a conservatory on the same level. The home fees are between £1430 and £1789 per week. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was a ‘key inspection’, which included a visit to the home. We visited the home on 6th February 2007. The manager, Gaynor Earle and the assistant manager helped us with the inspection. The visit started at 11.30am and lasted for four and a half hours. Some of the individuals who live in the home were at home during the inspection. Individuals helped us with the inspection, and two talked to us about living in the home. The main way of doing the inspection was using ‘case tracking’. This means looking at the care given to service users in different ways. The ways this was done are: • talking to the individuals who live in the home • talking to staff and the manager • watching how individuals are given support • looking at written records. All the key standards were checked during this inspection. The information below is based only on those aspects checked in this inspection. Details about individual people has been kept out of the report, to make sure it is kept confidential. What the service does well:
There has not been anyone new coming to live in the home for a long time, because all the individuals are settled in their home. Individuals living in the home continue to be well supported by staff There are very good care plans in the home for each individual. Care plans tell about what is important for each person living in the home, and about how they want to live their daily lives. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff communicate with individuals about what choices they want to make in their lives. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about how people who live in the home can be helped to do the things they want to do and be kept safe. Staff support each individual to do the things they want to do. Individuals told us about the different things they enjoy, like shopping, dancing, bowling, going to church and going out with friends. Some
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 6 individuals go to college and learn new skills. Staff support people to do what they want to do. Some people who live in the home have friends and family that they keep in touch with. Staff help each person who lives in the home to see people they want to see. Individuals are supported to be as independent as they are able to be. They are able to spend time in their own bedrooms or with other people. Individuals help to keep the house running smoothly, doing tidying and cleaning. Individuals eat their meals in the kitchen or dining room/lounge. Staff support individuals to prepare meals if they want to. Individuals enjoy a variety of different meals and can choose what they want to eat. Staff support individuals to be healthy and to have a good diet. Staff support individuals to look after their health and personal care. Individuals are encouraged to be as independent as they can, but staff help if they need help. Staff understand very well the different wishes of individuals in how they like to look after themselves. There are lots of ways that staff support individuals to stay healthy and to get medical help if they need it. There are very good ideas to help people to feel relaxed and well, like sensory equipment in bedrooms. Individuals keep their medicines in locked cabinets in their own bathrooms. Staff help individuals to make sure they take any medicines they need. All staff have had training about how to give out medication safely. Individuals can make a complaint if they want to about anything they are not happy with. Not everyone living in this home would be able to easily make a complaint. Staff spend time communicating with individuals to find out if they are ok and if they are happy with everything. Staff understand how important it is to make sure that individuals can live safely in their own home. Staff have had training to help them to keep individuals safe from abuse or harm. Individuals’ money is kept safely. The individuals keep their home very clean, tidy and well looked after. All individuals have large bedrooms and good-sized en suite shower rooms and toilets. Every individual has their own things in their bedrooms. The home is well decorated and individuals were able to choose the colours. The colours are good for helping people who have visual impairment to find their way in the home. Individuals are able to go where they want to in the home independently. Staff make sure that the home is safe for everyone to live in, like having contact with the fire service and making sure all fire safety equipment work properly.
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 7 The laundry has all the equipment needed to make sure that individuals can do their washing when they need to. There are a lot of staff in the home, to help individuals to be as independent as they can be and have choices. This is really good. Staff are chosen to work in the home who are safe and able to support people well. Staff are given training to show them how understand different needs of individuals and how to give the best kind of support. The manager of the home has supported individuals for a long time. Staff in the home said that the manager is very supportive to them also, and they can talk to her openly. Staff communicate with individuals to get their feelings about the home and whether everything is alright for them. There are policies in the home, which tell staff about how to work safely. Staff have had training to make sure they work safely, like how to use fire safety equipment, and how to stop infections spreading. 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.
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 8 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 Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 9 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): 2 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from good ongoing assessment of their needs, so that staff can continue to ensure they can live comfortably in their home. EVIDENCE: There has not been anyone new coming to live in the home for a long time, because all the individuals are settled in their home. Individuals living in the home continue to be supported by staff. The staff make sure that they keep checking what individuals need to make their lives fulfilling. Staff have training to help them to learn any new skills they might need to be able to support individuals – for example learning about dementia and the needs of older people. Other people are involved, like social workers, GPs and families, to make sure that the care given is right for individuals. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 9 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from excellent attention to individual needs and choices. EVIDENCE: There are very good care plans in the home for each individual. Care plans tell about what is important for each person living in the home, and about how they want to live their daily lives. The care plans are written in plain English and are different for each individual. It is not just records that are good in the home. Staff know what each person who lives in the home needs, and about the things they like and don’t like. Staff communicate with individuals about what choices they want to make in their lives. Some people living in the home use non-verbal ways to communicate, like touch or using objects to tell about different things. People who live in the home can choose things that they want to do. There are risk assessments in the home for each person. Risk assessments tell about
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 11 how people who live in the home can be helped to do the things they want to do and be kept safe. Staff support each individual to do the things they want to do. Where there are difficult choices, staff make sure that other people, like social workers or families are involved, so that everyone works to individuals’ best interests. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16, 17 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Individuals benefit from an excellent lifestyle in their home. EVIDENCE: Individuals who live in the home can choose to do different things they want to do. Individuals told us about the different things they enjoy, like shopping, dancing, bowling, going to church and going out with friends. Some individuals go to college and learn new skills. Staff support people to do what they want to do – and encourage them but do not force them to do things. Staff understand that individuals can have different choices and needs in their daily lives. This is very good. Some people who live in the home have friends and family that they keep in touch with. Staff help each person who lives in the home to see people they
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 13 want to see. Staff make sure that people living in the home have support from social workers and other people who can help them. Individuals are supported to be as independent as they are able to be. They are able to spend time in their own bedrooms or with other people. Staff spend time with individuals to do what they choose to. Two individuals went out to do keep fit during the day, and one was supported by a member of staff to do keep fit at home. Individuals help to keep the house running smoothly, doing tidying and cleaning. Everyone does their washing and ironing, with support from staff if they need it. Individuals eat their meals in the kitchen or dining room/lounge. They can choose to eat together or on their own if they want to. Staff support individuals to prepare meals if they want to. One individual said that they like making cakes and bread. Individuals enjoy a variety of different meals and can choose what they want to eat. Staff support individuals to be healthy and to have a good diet. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19, 20 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from excellent personal and healthcare support in their home. EVIDENCE: Staff support individuals to look after their health and personal care. Individuals are encouraged to be as independent as they can, but staff help if they need to. Staff understand very well the different wishes of individuals in how they like to look after themselves. Individuals are able to choose different things, like which clothes they want to wear, or whether they want to wear make up. There are lots of ways that staff support individuals to stay healthy and to get medical help if they need it. Staff give very good support to individuals to get ready for any hospital appointments or treatment they need. There are very good ideas to help people to feel relaxed and well, like sensory equipment in bedrooms.
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 15 Individuals keep their medicines in locked cabinets in their own bathrooms. Staff help individuals to make sure they take any medicines they need. Staff keep records of medicines which have been given. All staff have had training about how to give out medication safely. Individuals’ GPs are involved in making sure that people are taking the right medicines. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22, 23 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals are able to express if they are not happy about things and be listened to. Individuals benefit from good protection from abuse and harm. EVIDENCE: Two individuals who spoke to us said that they felt able to talk to staff if they were not happy about something. Individuals can make a complaint if they want to about anything they are not happy with. There have been no complaints made since last time we inspected this home. Not everyone living in this home would be able to easily make a complaint. The manager said that staff spend time communicating with individuals to find out if they are ok and if they are happy with everything. Staff understand how important it is to make sure that individuals can live safely in their own home. Staff have had training to help them to keep individuals safe from abuse or harm. Individuals’ money is kept safely. Staff support individuals to keep records of how they spend money. The manager of the home checks the accounts to make sure that individuals are protected. Applegarth DS0000001826.V327503.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): 24, 30 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from living in a very well looked after home. EVIDENCE: All shared rooms and bedrooms are on the ground floor of the house. The staff sleep-in room is upstairs. The individuals keep their home very clean, tidy and well looked after. The home has been made bigger so that all individuals now have large bedrooms and good-sized en suite shower rooms and toilets. Every individual has their own things in their bedrooms. The home is well decorated and individuals were able to choose the colours. The colours are good for helping people who have visual impairment to find their way in the home. Individuals are able to go where they want to in the home independently. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 18 Staff make sure that the home is safe for everyone to live in, like having contact with the fire service and making sure all fire safety equipment work properly. The laundry has all the equipment needed to make sure that individuals can do their washing when they need to. There is plenty of room in the laundry for individuals and staff to do washing and ironing. The laundry is very clean. Applegarth DS0000001826.V327503.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): 32, 33, 34 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from supportive, safe and well-trained staff. EVIDENCE: There are a lot of staff in the home, to help individuals to be as independent as they can be and have choices. This is really good. At night, one member of staff stays awake, and one member of staff sleeps upstairs. Staff are chosen to work in the home who are safe and able to support people well. Staff are given training to show them how understand different needs of individuals and how to give the best kind of support. Staff learn about different kinds of health conditions, like epilepsy, strokes and dementia. They also learn about how to do things safely, like giving medication, and preparing food. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Quality in this outcome area is excellent This judgement has been made using available evidence including a visit to this service. Individuals benefit from very good management in this home. EVIDENCE: The manager of the home has supported individuals for a long time. Staff in the home said that the manager is very supportive to them also, and they can talk to her openly. The manager makes sure that she continues to learn about the best ways to support individuals. Staff communicate with individuals to get their feelings about the home and whether everything is alright for them. Staff can give their ideas about anything they think could be done better to support individuals. The manager makes sure she does checks to see everything is going well in the home, like
Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 21 checking how staff are working. The owners of the home also do checks to make sure everything is running smoothly. There are policies in the home, which tell staff about how to work safely. Staff have had training to make sure they work safely, like how to use fire safety equipment, and how to stop infections spreading. Staff do checks to make sure that equipment in the home is safe. Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 22 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 4 23 4 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 4 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 x 4 X 4 X X 4 X Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 23 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 Applegarth DS0000001826.V327503.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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
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