Inspection on 22/11/05 for Ball Tree Croft

This inspection was carried out on 22nd November 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 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

Ball Tree Croft 09/08/06

Ball Tree Croft 27/06/05

Ball Tree Croft 04/10/04

Ball Tree Croft 22/04/04

Ball Tree Croft 12/08/98

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

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

CARE HOME ADULTS 18-65 Ball Tree Croft Western Road North Sompting Lancing West Sussex BN15 9UX Lead Inspector Mrs L O’Donnell Unannounced Inspection 22nd November 2005 02:00 Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Ball Tree Croft Address Western Road North Sompting Lancing West Sussex BN15 9UX 01903 753330 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.westsussex.gov.uk West Sussex County Council Ms Deborah Janet Clark Care Home 16 Category(ies) of Learning disability (16) registration, with number of places Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 27th June 2005 Brief Description of the Service: Ball Tree Croft is a Care home registered to provide accommodation for up to 16 Service Users with Learning Disabilities between the ages of 18-65.The home is situated within Sompting, next to a doctors surgery and within walking distance of other local amenities. The home has its own mini bus and car. Accommodation is provided within two units, each consisting of eight single bedrooms, lounge/dining area, kitchen, laundry and bathroom facilities. The Registered Providers of the service are West Sussex County Council. The Council have undertaken a consultation process on the future of the home and a decision has recently been taken to close the home once new services have been created. It is anticipated that this will take between 2 – 3 years. During this time the current residents of the home will be supported to find alternative accommodation through the ‘Place to Live’ project. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an Unannounced Inspection, which took place over 5 hours during the afternoon and early evening. Prior to the inspection the Inspector reviewed the previous inspection report and any other communication received since the last inspection. During the inspection the inspector spoke with residents, staff and the Registered Manager. A variety of records were also reviewed. Residents, where able to speak with the Inspector, spoke positively of their life within the home and the variety of both educational and leisure activities they enjoyed. Staff demonstrated a good understanding and awareness of the current and changing needs of the residents and how these were best met. What the service does well: What has improved since the last inspection? What they could do better: Standards of care at the home continue to be of a good standard. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 6 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. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 individual needs of prospective residents are assessed prior to admission to the home. EVIDENCE: The records and care plans for new residents who have moved into the home since the last inspection were seen. These showed that a full assessment of the individual needs of these residents had been assessed by Social and Caring Services and a Statement of Need and outline care plan had been provided to the home. These assessments covered all aspects of the personal, social and health care needs of the residents and were seen to form the basis of the homes own care plan. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 An individual care plan is in place for each resident within the home, which provides detailed information as to the needs of each resident and how these are to be met. Residents are able to make decisions about their lives with support from staff as necessary. EVIDENCE: During this inspection the care plans of four residents were seen. The home uses a standard format for the care plans and these provide information on the individual needs and guidelines for staff as to the support each resident needs. Within each of the care plans there were also guidelines for daily activities. Personal care needs are identified and any staff support or action needed to promote the residents independence is recorded. Key workers are matched to individual residents and those residents who were able to do so confirmed who their key worker was and what support or help they gave them. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 10 It was clear from the records seen that staff at the home use a person centred approach to care planning. The records of a care-planning meeting were seen within two of the care plans. These showed that the meeting was led by the wishes of the resident concerned and that the aims and objectives agreed at the meeting were as expressed by the resident. A person centred plan is then developed from these meetings which outline identified activities, staff support required and future goals. In one care plan these identified goals were portrayed in picture format with a pathway representing stages of achievement leading to the ultimate goal for the resident. Other parts of the care plan are also produced in a picture format and written as if by the residents themselves. Through the records seen, particularly in relation to the person centred care planning approach, it was clear that residents are supported to make decisions about their own lives, and set their own goals and objectives. Where residents are no longer able to make their own decisions, the person centred planning approach is still used but may involve more input from other health professionals involved in that residents care. It was evident through records seen and discussions with staff that there are a number of staff who have worked with and supported these residents for a long time and have developed an understanding of them, their needs and their personal preferences. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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, 14, 15, 17 Residents are able to enjoy a variety of appropriate activities. Residents are supported to participate in the local community. Residents enjoy a variety of leisure activities both within and outside the home. Residents are able to maintain family contact and friendships with staff support as needed. A varied and balanced menu is provided for all residents. EVIDENCE: A number of the residents attend local day services, which offer a variety of activities for the residents. Residents who attend confirmed that they enjoy cooking, art and craft and musical activities. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 12 Residents where able, would be supported by the staff team, to find appropriate volunteer or other work placements, with one resident currently a volunteer at a local charity shop. A number of residents who are now older have chosen not to attend the day services. There is an activities co-ordinator who works at the home who provides a variety of leisure and educational opportunities for these and all residents at the home. These have included cookery, art groups, gardening and day trips. Residents have also been able to attend training sessions in areas such as personal safety, first aid and health eating. In addition the Registered Manager, with other staff, is currently developing a new day service on site at the home. Although this will be a resource for the community, the residents at Ball Tree Croft will be supported to use these services. It is anticipated that a variety of activities and opportunities will be available. (Access to the service will be completely independent of the home and not affect the privacy of the residents.) Residents are supported by staff to access the local community. During the inspection one resident had returned from a shopping trip in the local town. Other residents spoke of going to the shops and other amenities within the area. Residents also enjoy a number of evening social activities including a regular disco held at the home and clubs elsewhere. Some residents have already enjoyed holidays this year with others having holidays planned in the near future. Observations made during the inspection showed that staff support residents to maintain regular contact with their family and friends, i.e. helping with telephone calls. In addition it was clear that residents are supported to develop friendships and relationships with support from staff and other professionals as necessary. Menus were seen which showed that residents have a choice of two main courses, with a further choice for dessert. All residents who were able to advised that they enjoyed the meals served. Residents were observed to help with preparing the dining tables prior to the meal, and help clearing up afterwards. Some residents have an identified need for support during mealtimes and staff were observed to provide this help and assistance. The mealtime generally was observed to be relaxed with residents able to enjoy their meal at their leisure. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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, 20 Personal support is provided in accordance with residents wishes and needs, in a way that promotes their independence. Good practice in the administration of medication was noted. EVIDENCE: All personal care needs of the residents are recorded within their care plans. These are produced in a picture format and are written as if by the residents. It was noted that these focus on what residents can do, whilst providing information for staff as to the support or assistance required as necessary, thus promoting the independence of the residents. Some residents were able to confirm that staff only help when they need it. The home has appropriate policies and procedures in place for the administration of medication. All medication was seen to be stored securely and all records seen in relation to its administration were up to date. There is a member of staff who has delegated responsibility for overseeing all aspects of the receipt, storage and return of medicines. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 14 Homely remedies are available and it was noted that there is an agreement in place with the local surgery as to what can/cannot be given. At the time of the inspection one residents medication had been reviewed and changed and it was noted that a member of staff was producing guidelines for staff as to how this is to be managed within the home, both for storage and administration. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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): 23 Residents are safeguarded from abuse in accordance with written policy. EVIDENCE: There are appropriate policies and procedures in place in respect of adult protection and prevention of abuse. In addition the West Sussex Guidelines for Adult Protection are available. Staff training is also available in this area. Through discussion with staff it was clear that they had an understanding of their role and responsibilities. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 28 Residents live in a comfortable and safe environment. Residents have access to both internal and external communal space. EVIDENCE: At the time of inspection the home was comfortable and clean and provided sufficient light and heat. At present the home meets the current needs of the residents. However as there is no lift access any wheelchair users only have access to the ground floor. (There are toilets and bathing facilities on the ground floor and all communal areas are also on the ground floor.) There are appropriate and adequate furnishings within the lounge/dining areas to meet the needs of the current residents. The Commission has received a copy of the latest Fire Safety Officers report and the Registered Manager confirmed during the inspection that any identified recommendations have been completed. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 17 Within each of the houses there is a lounge/dining room. Each provides both comfortable lounge furniture and appropriate dining furniture. In one of the houses the arrangement of the furniture was discussed with staff as the room appeared crowded with little space. The inspector was advised that the furniture has been moved around to find a more suitable arrangement and that this is discussed at the residents meetings. It is however recommended that the current arrangement be reviewed to ensure that all residents have safe and appropriate access to the room. In addition there is a large communal room which residents were observed to use and sit in. The room is also used for the weekly discos held. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 18 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): 33, 34, 36 Residents are supported by an effective and committed staff team. There is an appropriate recruitment procedure in place. Staff are supported and appropriately supervised. EVIDENCE: There are sufficient numbers of staff on duty to support the residents within the home and meet their needs. Staffing hours available have been increased since the last inspection to allow for additional 1-1 support for one resident and further hours for 1-1 with another resident. It was observed during the inspection that staff are able to spend time individually with residents to enable them to undertake activities both within and outside of the home. Staff demonstrated a good understanding and awareness of the current and changing needs of the residents. They were observed to be accessible to residents and the residents were relaxed with them. A number of residents have some specific needs in relation to communication and staff were observed to be able to communicate effectively with them. Staff spoke of developing and understanding nonverbal communication. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 19 It has been assessed on previous inspections that an effective recruitment procedure is operated within the home. This could not be fully assessed at this inspection as no new staff had been employed since the last inspection. Through discussions with senior and care staff it was demonstrated that regular staff supervision is held within the home. In addition a number of staff meetings are held within the home on a regular basis, these include house meetings, care staff meetings and senior staff meetings. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 Residents benefit from a well managed home. There are effective quality assurance and monitoring systems in place. The health, safety and welfare of residents is promoted and protected. EVIDENCE: The Registered Manager is appropriately qualified and experienced. She has a number of years management experience. During this inspection she again demonstrated a good understanding and awareness of the needs of the residents within the home, particularly in the changing needs of some residents and how best the home can continue to support and assist them to lead fulfilling lives. At present the Registered Manager is developing further services at the home which will benefit the current residents by providing further opportunities for educational and leisure activities. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 21 The management approach is open and inclusive. The views of the residents are sought in a variety of ways including person centred care planning and meetings. A newsletter is produced each quarter. This provides information about activities within the home, staff changes, activities enjoyed, residents achievements and forthcoming events. From records seen and discussions with staff it was demonstrated that as far as is reasonably possible the health and safety of residents and staff is promoted. There are policies and procedures in place in respect of all aspects of health and safety. Risk assessments are undertaken for any identified risk and the action to be taken to minimise this. Training is also available to both staff and residents. Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X 3 X X X Standard No 22 23 Score X 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 4 3 X X X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 X X X 3 X X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 4 15 3 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 X X 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Ball Tree Croft Score 3 X 3 X Standard No 37 38 39 40 41 42 43 Score 3 X 3 X X 3 X DS0000037421.V264417.R01.S.doc Version 5.0 Page 23 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 Ball Tree Croft DS0000037421.V264417.R01.S.doc Version 5.0 Page 24 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. 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