Inspection on 19/04/05 for Applemead

This inspection was carried out on 19th April 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Applemead 15/09/09

Applemead 05/07/07

Applemead 11/08/06

Applemead 04/10/05

Applemead 23/09/04

Applemead 27/04/04

Similar services:

2 Perhaver Park

The Vicarage

7 Hyde Road

St George`s

5 Seafield Road

Credence House

Radfords

Trevaylor Manor

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

CARE HOME ADULTS 18-65 Applemead Station Road Whimple Exeter EX5 2QH Lead Inspector Bel Heginworth Announced 19 April 2005 th 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. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Applemead Address Station Road, Whimple, Exeter EX5 2QH 01404 823332 01404 823382 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) Sense Mr Jason Wright CRH PC Care Home providing personal care 6 Category(ies) of LD Learning Disability [6] registration, with number PD Physical Disability [6] of places SI Sensory Impairment [6] Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: NO Date of last inspection 23rd September 2004 Brief Description of the Service: Applemead provides support and personal care to people with a learning disability and senory impairrments. The house is a six bedroomed house located in the village of Whimple. The home is a few minutes walk away from the village and is less than 2 minutes away from the station. It is approximately 9 miles from the city of Exeter. Bedrooms are situated on the first floor of the house along with two bathrooms and integral toilets. The downstairs comprises of an office, kitchen, lounge / dining area, conservatory, a quiet soft padded “snoozelem” room, a shower room with toilet and laundry room. There is a sensory garden to the rear of the property. Some adaptations have been made to meet the needs of each deaf / blind person. The home is operated by the organisation SENSE, who specialise in sensory impairments. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A number of the residents living at Applemead have limited verbal communication skills therefore were unable to contribute fully to the inspection process. Time was spent with residents at various points of the day and observations were made. Throughout this report residents are referred to as the deaf / blind person. This is the choice of Sense. This announced inspection took place over 7 hours. The provider’s representative, Mr Philip Welsford and the finance officer, Shelia Appleton were present through most of the day. Due to unforeseen circumstances, the registered manager, Mr Jason Wright was not present. Five staff were consulted and their views on the service discussed. The inspector looked round parts of the building and a number of records were inspected. What the service does well: What has improved since the last inspection? Information provided to prospective residents and relatives has improved. The Statement of Purpose has been expanded to give additional information. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 6 Additional security measures for medication and for storing files have been implemented. Evidence of staff police checks were available to inspect. Work has started to improve how care plans are organised to make them a more useable, working tool. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 The home provides good information to deaf/ blind people before admission. The home ensures that assessments on peoples’ needs are completed prior to admission. EVIDENCE: A requirement was made during the last inspection relating to the information required in the home’s statement of Purpose. This work has been completed. A requirement was made during the last inspection relating to the assessment process. This work has been completed. The deaf / blind people were unable to discuss their involvement in the admission process due to limited communication skills. The home has its own admission form, which is completed by the home’s manager with the involvement of the deaf / blind person and their relatives. It is a comprehensive document that assesses all areas of need and provides good information to the staff team. Care staff confirmed their knowledge of the deaf / blind peoples’ needs. They said that the assessments and subsequent care plans provided them with the information and guidelines they need. Information relating to the payment and use of transport must be added to the Statement of Purpose. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 standard(s) 6, 7 & 9 Care planning and risk assessments provide staff with the information they require to satisfactorily meet deaf / blind peoples’ needs safely. Some improvements are needed in relation to the decision making process and the accessibility of care plans. This is particularly important given that deaf / blind people have limited capacity to contribute to plans and decisions. EVIDENCE: The home has detailed care plans that provide good information about each deaf / blind person. It was recommended during the last inspection that care plans should be constructed in such a way that makes them more accessible to the staff. This has begun to improve in some care plans but not all. Relatives and care managers are involved in regular care plan reviews and are kept up to date with any changes of need or care to the deaf / blind person. Restrictions on choice or freedom are recorded and risk assessed in individual plans. For example the staff have taken relevant issues to a Good Practice Committee of professionals for advice. It was recommended during the last inspection that action recommended by these professionals should be implemented. This has been completed in most instances but not all. Risks are carefully identified and minimised. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 0 Not inspected on this occasion. EVIDENCE: Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 11 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) 19 & 20 The health needs of the deaf / blind people are well met. Good multidisciplinary working takes place on a regular basis. Medicines, administration and medical need are managed well. Improvements are needed in the medication training of staff and the administration of controlled medicines. EVIDENCE: Care plans confirm that healthcare needs are assessed regularly and the home has good links with local GP practices. The home uses specialist professionals to assess deaf / blind people with complex needs to provide guidance and training to the staff. The home uses liquid controlled medicine. On a number of occasions the amount of liquid in the bottle has been inaccurate resulting in a shortage or too much medicine left in the bottle. The manager should contact a pharmacist for advice on a more accurate way of measuring such medicine. Not all staff have received appropriate training on the “Safe Handling of Medicines”. The training should include training on medication policies and procedures. A competent trained person then needs to carry out an initial assessment of competence to ensure members of staff are following policies Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 12 and procedures and putting into practice their training. The assessment of competence will need to be reviewed on a regular basis. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 The home has good systems in place to protect deaf / blind people from abuse, neglect and self-harm. EVIDENCE: All staff have received Adult Protection training. Staff demonstrated a good awareness of Adult Protection and knew what to do if they suspected abuse. The home keeps good financial records which are clear, accurate and up to date. Policy and practice on the storage and handling of residents’ monies is good. There was evidence of regular audits and two signatures are provided for each transaction. Any significant spending is discussed with care managers and relatives. residents’ interests are thereby well protected. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 The standard of décor within the home is adequate with evidence of some improvement through maintenance or future planning. The kitchen is in urgent need of repair or replacement. Grab rails are urgently needed in the bathrooms upstairs. EVIDENCE: The home is designed to meet the needs of most deaf / blind people, it is bright airy and cheerful, it provides touch rails throughout to help the blind and partially sighted find their way around. A walk in shower room has recently been installed to give deaf/ blind people more independence. However, there are a number of tiles missing or broken. This is unsafe to a deaf / blind person. A soft padded ball poolroom is available for deaf / blind people who require quiet or safety from self-harm. The kitchen is unsafe. Some kitchen cupboards have come off and are in such a bad state of repair they cannot be put back on. This leaves deaf / blind people at risk from touching or moving the contents. Priority needs to be given to making the kitchen safe. There are no grab rails in the showers or baths upstairs which staff reported is Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 15 unsafe for the deaf / blind person. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 16 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) 34 & 35 Deaf / blind people are supported by an effective, competent and experienced staff team with recruitment practices that protect deaf / blind people. EVIDENCE: The home’s recruitment procedure and practices ensure that the necessary checks are carried out for the protection of deaf / blind people. A requirement was made during the last inspection in relation to CRB checks being available for inspection. This has been met; all CRB checks were seen. A training programme has been set up for the staff team. It covers all areas that the home has assessed as necessary to ensure that the team have the skills to meet the needs of the deaf / blind person. It was recommended during the last inspection that where carers are working with people with a learning disability, the Learning Disability Award Framework (LDAF) should be used in induction training. This will provide underpinning knowledge for the progress towards achieving NVQ qualifications and be specific to learning the needs of people of have a learning disability. This is still not being used. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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 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) 0 Not inspected on this occasion. EVIDENCE: Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 18 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. Where there is no score against a standard it has not been looked at during this inspection. 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 x Standard No 22 23 ENVIRONMENT Score x 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 2 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x 3 2 x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Applemead Score x 3 2 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 19 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 YA24 Regulation 23 (2) (b & n) Requirement The registered person must ensure the premises are of sound construction and kept in a good state of repair.Suitable adaptation must be made. (This refers to the kitchen and grab rails in the bathrooms) Timescale for action 30/07/05 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 YA1 Good Practice Recommendations Details of the items residents will be expected to pay for should be further clarified within the contracts, statement of purpose or terms and conditions of occupancy to ensure that staff, residents and/or their representatives know exactly what services are covered within the fees, and what items are considered to be ‘extras’ that the residents will be expected to pay for. (This refers to transport costs) The care plans should be constructed in such a way that it is a useable working tool. Actions recommended by other professionals on issues relating to restrictions should carried out. D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 20 2. 3. YA6 YA7 Applemead 4. YA35 Staff working in Learning Disability services should use the Learning Disability Award Framework (LDAF) accredited training to provide underpinning knowledge for progress towards achieving NVQs. Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 Page 21 Commission for Social Care Inspection Suite 1, Renslade House Bonhay Road Exeter EX4 3AY 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 Applemead D54 D06 S21878 Applemead V212276 190405 Stage 4.doc Version 1.20 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. 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. 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