Inspection on 19/04/06 for Badgers

This inspection was carried out on 19th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Badgers 03/10/07

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Southfields

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

CARE HOME ADULTS 18-65 Badgers Blackwater Lane Pound Hill Crawley West Sussex RH10 7RL Lead Inspector Mrs M McCourt Key Unannounced Inspection 19th April 2006 13:30 Badgers DS0000066060.V288627.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 Badgers DS0000066060.V288627.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. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Badgers Address Blackwater Lane Pound Hill Crawley West Sussex RH10 7RL 01293 885469 01293 885469 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) Evesleigh Care Homes Limited Post Vacant Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th November 2005 Brief Description of the Service: Badgers is a care home registered to accommodate up to four Service Users with learning disabilities. The Registered Provider is Eveleigh Care Homes Ltd and the Registered Manager’s post is currently vacant. The current scale of monthly charges ranges from £1,300 to £1,742. This information was provided on the pre-inspection questionnaire. No comment was made regarding additional charges. The home is a detached property, situated in a residential area close to Crawley town centre, which has access to all community facilities and is within easy reach of local rail and bus stations. Accommodation is provided over two floors. Each resident has their own bedroom, with one resident located on the ground floor, and the remaining three residents on the first floor. There is a large living room that includes a dining area, a smaller lounge and a large kitchen area. In addition the home has a garden with lawn and decking to the rear of the property. The Service Users Guide and Statement of Purpose, which incorporates inspection reports, are both located at the home and are accessible to Service Users, staff, relatives and anyone else interested in the service. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection was undertaken on Wednesday 19th April 2006 and lasted a total of five and a half hours. Pre-inspection planning took approximately three days. A full tour of the building took place and included the observation of Health and Safety matters, hygiene issues, decorative order and a general overview of the atmosphere created within the home. Two staff members, three residents and three managers from the company were spoken to at the time of inspection. Two days after the inspection, some follow-up matters were discussed with the Area manager and the Responsible Individual. Case tracking was carried out by examination of relevant records and information held on the staff and residents spoken with during the course of the inspection. In addition, follow-up information was obtained from a social worker assigned to one of the Service Users living at the home. Policies and procedures were examined both prior to the inspection, received with the pre-inspection document, and during the site visit. The overall outcome for Service Users is adequate. What the service does well: There is a good pre-admissions assessment process in place and Service Users and their relatives are consulted with in order to identify suitability to the home. The home is offers a wide range of activities and the staff team encourage regular access to the local community. Care plans are clear and easy to follow, enabling staff to provide consistent care and support to individuals. Together with responsible risk assessments, Service Users are able to achieve realistic personal goals, giving them a sense of confidence and well being. All residents spoken to reported that the food was good and that the meals were varied and balanced. Staffing levels are considered to be high and it was noted that agency staff are never used at the home. Badgers DS0000066060.V288627.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. Badgers DS0000066060.V288627.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 Badgers DS0000066060.V288627.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 The outcome for Service Users was found to be good. Service Users are consulted about where they choose to live prior to moving, and are certain that the home will meet their individual needs. EVIDENCE: Two Service Users personal files were examined during the inspection and were found to contain detailed pre-admission assessments. Care plans are compiled from the assessment process and included risk assessments, individual care needs and personal preferences. Some restrictions of choice have been documented within personal files. Discussion with three service users at the home confirmed that they had visited the home prior to moving, and that they had been able to choose colour schemes and personal items for their individual bedrooms. One Service User spoken with said that she wanted a T.V. in her own room. However, there have been issues around televisions being broken. In order to meet Service Users needs, consideration should be given to finding ways in which to support this to happen. Badgers DS0000066060.V288627.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 outcome for Service Users was found to be good. Service Users needs and personal goals are reflected in their care plans. Service Users are assisted to make decisions about their own lives, which includes taking responsible risks. EVIDENCE: The Inspector examined two individual care plans as part of the case tracking process. Those seen provided good, clear information about the abilities and disabilities of the resident, with specific guidance on how best to support the person. Records relating to the monitoring of behaviour, health and goals were included. Staff spoken with confirmed that they are able to follow the information contained within the care plans. It was noted and further discussed with the manager that both of the care plans looked at were in need of review. Risk assessments looked at had not been reviewed for five months, with the latest date of review being November 2005. Goal plans and care plans had not been reviewed for one year. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 10 The Inspector spoke with three Service Users in order to obtain their views on life at the home. It was confirmed that with guidance and support from staff they are able to make decisions about their lives and do take risks as part of achieving an independent lifestyle. The Inspector was told by Service Users that they regularly went out into the community to enjoy various leisure activities, such as; cinema, shopping, eating out, visiting friends and walking into the local town. One Service User told the Inspector that she saw a family member last week and is able to telephone them regularly throughout the week. It was also confirmed that visitors could be seen in private if the Service User wishes. In further discussions the Inspector was told that it was good living at Badgers and the staff are nice. Another Service User said that they were looked after very well by the staff. Badgers DS0000066060.V288627.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 and 17 The outcome for Service Users was found to be good. Service Users are able to take part in a range of appropriate activities within the local community. Service Users are supported with family relationships and guided to develop personal friendships. Meals are varied and nutritious. EVIDENCE: Service Users are encouraged to access the community through involvement in various leisure activities and by participating in college programmes. Two Service Users spoken with said that they attended college on a weekly basis. On the day of inspection all of the Service Users accommodated at the home had been supported to go out. Staff took some Service Users on a drive to Brighton, a third person had returned from a shopping trip and yet another had been out and was going out again in the evening with a friend. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 12 Service Users are encouraged to pursue individual interests and hobbies, and within the home they are able to choose from watching T.V., listening to music, reading and so on. The Inspector observed staff reading stories to a Service User. There were positive comments about the food, with one Service User telling the Inspector that it was ‘takeaway’ night, and tonight’s choice was Chinese, her favourite. Another Service User said that she chooses what she wants when she goes food shopping at the supermarket. A menu was included with the pre-inspection questionnaire and meals on it are varied and balanced. Badgers DS0000066060.V288627.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 and 20 The outcome for Service Users was found to be adequate. Service Users receive personal support in an appropriate manner and suited to individual need. The home is able to provide physical and emotional care to individuals. Policies and procedures are in place to ensure the correct administration of medication. EVIDENCE: The Inspector observed interactions with Service Users to be appropriate. Personal records show details of healthcare appointments and also include the names and addresses of relevant professionals involved in individual care. Staff and Service Users have access to the Community Team for People with Learning Disabilities to assist with additional support and advice when required. However, the Inspector was of the opinion that there is some inconsistency in the care offered to one of the Service Users living at Badgers, and thought must be given to developing and maintaining long term goals to Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 14 ensure staff are proactive rather than reactive to behavioural issues. Following the inspection visit the Inspector spoke with the named Social Worker for the individual who confirmed that there are inconsistencies at times, and together with recent staff and management changes, there has been an impact on the Service User’s behaviour. It was thought that the home is often reacitve instead of proactive towards the behaviour of the Service User concerned. Procedures are in place to assist staff to work with Service Users who become agitated or display challenging behaviour, and staff members spoken with had received training on physical intervention. Although the home does have medication policies and procedures in place, the guidance on administration was not being followed on the day of inspection. The Inspector was told that this was because there were no other staff on duty that had received the appropriate medication training necessary, allowing them to co-sign. This was due to all permanent staff attending a training day. It is not uncommon for there to be only one medication trained person on shift, and therefore, thought should be given to how the home will meet their own policy when this situation arises. Badgers DS0000066060.V288627.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 and 23 The outcome for Service Users was found to be adequate. Procedures are in place to ensure complaints are dealt with appropriately. Systems are in place to protect Service Users from abuse, neglect and selfharm. EVIDENCE: A complaints policy and procedure is in place, and was sent to the Inspector prior to the inspection of the home. It was noted that the policy is still in the name of the previous provider and that it refers to The National Care Standards Commission. A letter received by the Inspector stated that all policies and procedures previously used within the group of homes would be adopted by the new provider and that they had been reviewed in February 2006. The letter went on to clarify that there would be a signed confirmation of this in all the Policies and Procedures files. However, on the day of inspection this was not the case, there was no confirmation on the files and individual policies had not been reviewed in February. Further discussion with both the Acting Manager and the Admin Manager confirmed that this had not yet been carried out. In order to ensure clarity of the systems within the home, this should be rectified as soon as possible. Policies and procedures such as; Adult Abuse, Bullying, Physical Intervention, Harassment and so on are in place to protect Service Users. The preinspection questionnaire confirmed that some staff had received training in the aforementioned subjects. However, the two members of staff spoken with at Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 16 the time of inspection had not had Adult Abuse training, although they were aware of what to do should they suspect a case of abuse. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 The outcome for Service Users was found to be adequate. The home is clean, bright and in good decorative order throughout. Service Users live in a comfortable and safe environment. EVIDENCE: On the day of inspection I found the home to be of reasonable clealiness. Maintenance issues were observed, for example posters were ripped off a wall in a quiet room and apart from the sofa and an empty wooden box where the television used to be, there was nothing else within the room. It looked uninviting. Upstairs, a Service Users bedroom, a bathroom and the staffs sleeping-in room were all in need or redecoration. There were two pots of paint in the sleep-in room and the manager told me that it was due to be painted soon. I was told that the whole house was due for redecoration, although the manager was not sure when this would be happening. The laundry room was untidy, but there were no risks or concerns visible. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 18 Whilst at the inspection the fire alarms sounded and the house was evacuated. This was carried out quickly and efficiently. A renewal and redecoration plan should be implemented in order to address the issues highlighted. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 The outcome for Service Users was found to be adequate. A competent and qualified staff team is appropriately trained to meet the individual needs of Service Users. Recruitment policies and procedures are in place to ensure Service Users are protected from harm. EVIDENCE: Discussion with the Training Manager did confirm that all new staff now undertake a Common Induction Standards course, which consists of a work book covering various subjects. It is in-keeping with the SKILLS FOR CARE and linked to NVQ. The staff member completes the workbook which is monitored throughout by the Training Manager. However, as previously highlighted, a Training & Development Policy should be implemented. Signs posted on office wall were misleading. They claimed that 50 of staff were NVQ trained, but on discussion only two members of the staff team held the qualification. Also there were more percentages around mandatory training on display, which again are now out of date. It was noted that there is currently a problem regarding retention of staff. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 20 On the day of inspection the Inspector was unable to examine the recruitment records for the staff on duty as they are not kept on the premises. All records for Bank staff are kept at a central location. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 21 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 and 42 The outcome for Service Users was found to be adequate. The manager should develop policies and procedures to reflect the needs of the Service Users and the day-to-day running of the home. The manager should consider implementing a more specific quality audit tool to improve the home’s ability to self-monitor and develop, ensuring Service Users’ views and those of family and relatives are sought on a regular basis. Health & Safety policies and procedures require updating to ensure the protection of Service Users. EVIDENCE: Currently Jane Ashby is the acting manager responsible for the day-to-day running of the home. Ms Ashby has completed the paperwork necessary to apply to become the Registered Manager. The previous manager resigned from the post in December. The Registered Managers post has been vacant Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 22 for more than four months now and this is impacting on the level of service provided. The Inspector discussed with both the Acting Manager and the Admin Manager the importance of regularly reviewing and updating the policies and procedures. Further discussions took place around the idea that the manager of the home should be reviewing the homes own policies and procedures, rather than the current practice of the Responsible Individual doing it, as some documents need to be specific to the home and to the particular requirements of the client group. The Inspector discussed quality assurance with the Admin Manager and was told that a survey has just been conducted for Service Users, staff, care managers and next of kin. The results are to be compiled and published for the conference to by held on 2nd May 2006. A copy of the report will be forwarded to the Commission for Social Care Inspection. The accident book was examined by the Inspector. Three major incidents have occurred since the last inspection, and these have all been managed appropriately. As previously highlighted, some policies and procedures require updating, in particular the Medication Policy and the Food Hygiene Policy. Regulation 26 reports are sent to The Commission for Social Care Inspection at regular intervals. However, several issues highlighted on the most recent report had not been carried out within the four-week, timescale. This was discussed at the time with the manager who agreed to address the situation. A member of staff informed the Inspector that staff wages were not always being paid on time. The Inspector looked at financial records and spoke with the manager, who confirmed that in addition to wages, there had been some weeks when the cheques for the home’s expenditure had not arrived on time. Two days later the Inspector was contacted by the Area Manager and later that same day, the Responsible Individual with whom these issues were raised. The Inspector was told that there have been problems with cheques and miscommunications between telewest and BT, resulting in phone lines being temporarily restricted. It was explained that due to the company changing financial systems, there had been some problems, but that these were now being addressed. Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 23 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 2 23 3 ENVIRONMENT Standard No Score 24 2 25 x 26 x 27 x 28 x 29 x 30 3 STAFFING Standard No Score 31 x 32 2 33 x 34 3 35 2 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 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 2 x 3 x x 2 x Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 24 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 2 Standard YA37 YA40 Regulation 8 17 Requirement The registered provider shall appoint an individual to manage the care home. The registered person shall ensure that records are kept up to date. Timescale for action 30/06/06 30/06/06 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 Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Worthing LO 2nd Floor, Ridgeworth House Liverpool Gardens Worthing West Sussex BN11 1RY 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 Badgers DS0000066060.V288627.R01.S.doc Version 5.1 Page 26 - 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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