Inspection on 24/05/06 for Belchford

This inspection was carried out on 24th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Belchford 24/05/07

Belchford 31/01/06

Belchford 10/08/05

Belchford 12/11/04

Belchford 12/05/04

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

CARE HOME ADULTS 18-65 Belchford Belchford Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB Lead Inspector Stephen Willcock Unannounced Inspection 24th May 2006 10:00 Belchford DS0000007457.V294136.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 Belchford DS0000007457.V294136.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. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Belchford Address Belchford Hesleden Road Hesleden, Blackhall Hartlepool TS27 4PB 01429 836286 01429 836286 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) londonroad@tiscali.co.uk Milbury Care Services Limited Care Home 7 Category(ies) of Learning disability (7) registration, with number of places Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 31st January 2006 Brief Description of the Service: Belchford provides residential care for up to seven people who have a learning disability. Fees are charged according to the service user’s assessed need and can range between £1000 and £1200 per week. There is also a small additional charge towards the cost of transport. The home is a detached house with large grounds, in a rural setting. The centres of Durham and Peterlee are easily accessible by car. The home is managed by Milbury Care, an organisation that specialises in services for people with a learning disability. The Milbury organisation is part of the Paragon Group. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on 24th May 2006 over a period of 5 hours and time was spent talking to service users, staff and management. Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. However some service users were keen to show me their home and appeared happy and contented with life at Belchford. Service users showed that they got on well with staff and it was seen that staff made good effort to be a part of the service users’ activity, especially in the greenhouse, and going out of the home to the local community. Members of staff who spoken to during the inspection were knowledgeable and able to demonstrate appropriate care values and attitudes. There were no relatives or health professionals present during the inspection. No responses to the Commission for Social Care Inspection survey were received. There were some areas of concern that have been highlighted in the report especially around the proposed refurbishment of the home but it is hoped that work will soon be started to bring the home back to what is a very presentable country house. It is expected that the new manager will carry out the recommendations contained within this report. What the service does well: What has improved since the last inspection? Since the last inspection there has been some improvement to the exterior grounds with the addition of a car parking area and an electronic operated security device on the gate. After a period of management changes, a new manager has been appointed who has the experience and established ability to manage the home. Staff Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 6 spoken to during the inspection expressed confidence in a more stable management and continuity for the future. 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. Belchford DS0000007457.V294136.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 Belchford DS0000007457.V294136.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 and 3 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Assessment of service user needs is carried out prior to admission to the home. Any changes in service user needs are quickly identified but, where building work is required, these needs have not yet been met. EVIDENCE: A number of service users’ individual care plans and assessment records were looked at and seen to contain good detail. The records showed when the service user moved into the home and what their needs would be and how the home would be able to meet those needs. It was seen that as each service user’s needs changed, as identified by regular review of their care plan, the care they received would be changed to meet their needs. However, recommendations made by an occupational therapist had not as yet been carried out. The assessment recommended that a hi-lo bath and hoist be made available for a service user who needed the assistance of special bathing equipment. The manager said there was a refurbishment plan for the home and it was expected that the new bath and hoist would be provided soon. Belchford DS0000007457.V294136.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home responds to service users’ changing care needs and personal goals. Staff members assist service users to make decision about their lifestyles and provide support to carry out the choices they have made. Where risk has been identified in a service user’s chosen lifestyle or decision, the home ensures an assessment is carried out and reviewed to minimise the risk. EVIDENCE: Care planning is carried out on a regular basis with the service user and their representative if possible. Care plans are detailed and cover all aspects of personal and social support needed. Where necessary, the plan includes details about how staff would be able to meet the needs of any challenging behaviours displayed. The new manager said it was intended to review the format and structure of the care plans to follow a person centred approach and to ensure all information was updated. It was noted that information relating to Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 10 medication for one service user had not been updated in the care file since a change in the prescribed medication. It was seen that service users were supported to make decisions about their lifestyles, including planning for future events such as holidays and trips outside of the home. One service user had shown interest in growing plants in the garden and had decided to enjoy spending time in his greenhouse rather than in the main home. Staff members were seen to be supportive of his decision and encouraged the service user to make good use of the greenhouse. Risk assessments had been completed for each service user and cover many aspects of their daily lives. The assessments were regularly reviewed and updated. New risk assessments were developed when any new activities were introduced or an element of risk was identified. Belchford DS0000007457.V294136.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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users have opportunities to take part in appropriate activities at the home, and within the local community. Links with family and friends are encouraged and service users’ rights are respected. Meals and mealtimes are arranged to meet service users’ preferences. EVIDENCE: Currently none of the service users were engaged in educational placements or employment but there was a high level of developing daily living skills within the home, dependent upon the ability of the individual service user. There were also opportunities to take part in fulfilling activities within the home environment. Although the home occupied an isolated position in its own grounds there were good links with the local community. Service users often went to the local village for shopping or to the nearest town using the homes own transport. An activity plan was in place for each service user and included details of regular Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 12 outings and meeting with other service user at various social events. The manager said further links with the community were to be developed. The manager said family and friends of service users are invited to the home at any time and to take part in the care of their relatives. Service users take part in social activities, including events at local pubs, and these provide good opportunities to meet old friends and to make new friends. Service users take part in the daily routines of the home and are encouraged to be as independent as possible and to take care of their environment to their individual ability. The large gardens allow service users the opportunity to spend time in private and to enjoy their own pastimes. One service user often works in the greenhouse and enjoys his privacy while tending to the plants. Mealtimes at the home are flexible and menus dependent upon service users likes and dislikes. A structured menu has been prepared but service users often choose to eat something different or to go out for lunch. Belchford DS0000007457.V294136.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 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Personal care is given to service users depending on their preference, although the provision of specialised bathing equipment has not been put in place. Health care is maintained and although medication is handled appropriately, some updating of information is needed. EVIDENCE: Staff at the home provide personal care and support to service users, respecting the way each service user wants to receive their care. However, an occupational therapist report that detailed the needs of one service user had not yet been acted upon. The report identified that a specialised shower and hoist should be used, requiring alterations to the homes bathroom. A refurbishment plan was produced to include these alterations but work has not yet started. There is regular contact with local doctors and other healthcare professionals either through a visit to the surgery or at the home. District nursing services and community psychiatric services are also involved in the service users care and maintain a regular link with the home. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 14 The storage and recording of medication used at the home followed procedures developed by the Milbury organisation and the supplying pharmacy. It had been noted by the manager that some updating was required especially where case file records for one service user did not show the current medication in use as recorded on the monitored dosage record. Belchford DS0000007457.V294136.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 Quality in this outcome area is good. This judgement has been made using available evidence and a visit to this service. The home has an effective complaints procedure. Staff members are trained to respond appropriately to adult protection issues. EVIDENCE: The Milbury organisation’s corporate complaints procedure is available at the home and details how a complaint can be made and what response can be expected. During the last 12 months, no complaints have been received by the home. The home has a policy and procedure to follow in the event of an adult protection issue and there is an ongoing programme of training in the Protection of Vulnerable Adults. Training has also been provided to enable staff to respond to challenging behaviour and procedures are in place to safeguard service users financial affairs. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 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 and 30 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The home is in need of redecoration and refurbishment. The home is clean and hygienic. EVIDENCE: The home is located in large grounds that are set away from the main road. Recently some improvements have been made to ensure the security of service users by the installation of an electronic locking system to the gates to the front of the home. A car parking area has also been provided. A refurbishment plan has been produced to update the home and provide for specialised bathing equipment as previously noted in this report. However no work has as yet been started. The home is in need of a lot of redecoration and repair. Some furnishings are showing signs of wear and are in need of replacement and in a bathroom, a radiator fitting needed to be secured. In one service users bedroom, it was noted that the bedroom carpet was stained and needed refitting. Staff and service users at the home ensure as far as possible, that the home is maintained in a clean and hygienic manner. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 17 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 and35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by qualified and competent staff. An appropriate recruitment procedure and training is in place to meet the needs of service users EVIDENCE: Staff at the home regularly take part in further training to meet the needs of service users, and some staff have been in their present post a number of years, building up a good understanding of individual service users needs. In discussion, a staff member was very clear about his role and had a good understanding of the rights and care of service users. Staff had undergone studies leading to the qualification of NVQ in care and currently most of the 14 staff members had achieved level 2, and some had achieved level 3 or were studying for it. The homes recruitment policies followed the Milbury organisations procedures. All staff employed at the home undergoes a Criminal Records Bureau check, provides references and take part in Induction and Foundation training. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 18 The home has a training plan in place and training is carried out using the organisations trainers or specialised trainers from a training agency. Mandatory courses including Fire Safety, Health and Safety and First Aid have been carried out and more specialised courses in Learning Disability, Autism and Challenging Behaviour are undertaken. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 19 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 Quality in this area is good. This judgement has been made using available evidence including a visit to this service. The home should benefit from the new managers competencies and capabilities. EVIDENCE: The home has recently undergone a number of changes in management, some lasting only a few months. The present manager has recently undertaken the position but has considerable management experience with a similar client group to draw upon. The manager is well qualified for the role having achieved NVQ 2, 3 and 4 in care and completed the Registered Managers Award. The manager is keen to review documentation and records held at the home and should provide a long period of stability for the benefit of service users and staff. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 20 In discussion, it was noted that the arrangements to gain the views of service users, families and professionals on how well the home is performing could be enhanced by carrying out a quality assurance survey. The manager said service users had opportunity to express their views on how the service is run and how their needs were met through service user meetings, but in view of communication impairments, a quality assurance survey would be developed. During the course of the inspection it was noted that several doors had a fire security device fitted. A number of the devices were not working correctly and required attention. The manager said that maintenance of the devices would be looked at in the refurbishment plan for the house and possible alternatives would be explored with the Fire Officer. Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 21 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 Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 22 CHOICE OF HOME Standard No Score 1 X 2 3 3 2 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 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 2 3 2 X 4 X 2 X X 2 X Belchford DS0000007457.V294136.R01.S.doc Version 5.1 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. 1. Standard YA18 Regulation 12 Requirement The registered person must make proper provision for the care of the service user as detailed in the occupational therapists report. The registered person must ensure the premises are in a good state of repair and carry out the planned refurbishment. Timescale for action 01/09/06 2 YA24 23 01/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard YA20 Good Practice Recommendations The manager should ensure that records of medication are accurately recorded in care plans. The manager should carry out a quality assurance survey. The manager should consult with a fire officer about the maintenance and use of fire safety devices. 2. 3. YA39 YA42 Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 24 Commission for Social Care Inspection Darlington Area Office No. 1 Hopetown Studios Brinkburn Road Darlington DL3 6DS 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 Belchford DS0000007457.V294136.R01.S.doc Version 5.1 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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