CARE HOME ADULTS 18-65
Benyon Grove (55-56) Herlington, Orton Malbourne Peterborough PE2 5GH Lead Inspector
Dragan Cvejic Unannounced Inspection 31st October 2006 10:00 Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Benyon Grove (55-56) Address Herlington, Orton Malbourne Peterborough PE2 5GH 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) 01733 361333 01733 231060 www.mencap.org.uk Royal Mencap Society Judith Ann Phillips Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (5), Physical disability over 65 of places years of age (1), Sensory Impairment over 65 years of age (1) Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 5 service users only in category LD9E) (over 65 with learning disabilities) to be accommodated, those service users` names to be confirmed in separate correspondence. 1 named service user only in the category PD(E) (over 65 years with physical disabilities), this person`s name to be confirmed in separate correspondence. 1 named service user only in the category SI(E) (over 65 years with sensory impairment), this person`s name to be confirmed in separate correspondence The above conditions of registration wil automatically cease once the named individuals are no longer living at 55-56 Benyon Grove. 28th February 2006 2. 3. 4. Date of last inspection Brief Description of the Service: 55 & 56 Benyon Grove provides accommodation, care, and support for up to 8 people with a learning disability, some of who have associated physical disabilities, and some of whom are aged over 65 years of age. The home is situated in a cul-de-sac on the outskirts of Peterborough and is close to local shops, a health centre, and a pub. Accommodation is provided in two detached bungalows, each having four bedrooms, a lounge/dining room, office, kitchen, bathroom and laundry; the houses are joined via a communal back garden. Practical and emotional support is provided by staff 24 hours a day including three waking night staff. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out during midday hours and lasted for 4.5 hours. Two service users and one staff were spoken to in addition to the manager and her deputy. The main methodology was case tracking, whereby 2 service users were case tracked. The tour of the premises and reading policies and procedures were also used to reach the judgements. The inspection covered all key standards. What the service does well: What has improved since the last inspection? Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 6 The home was constantly monitoring the standards of the services and provisions and regularly planned how to either maintain good standards or to exceed them. Environmental changes included building docking in the garden, fitting a new safer ramp in the garden, replacing a patio door and fitting extractor fans in bathrooms. Bathrooms were also equipped with ceiling hoists in addition to bath chairs. SU was allocated a patch in the garden that she uses to grow her vegetables. Bedroom doors were had photos and names of service users rather than being marked by numbers. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 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 Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home provided clear information about the service, allowing service users to make an informed choice about the chosen home, and ensuring that users needs were closely and regularly monitored in order to take appropriate actions and ensure that their needs were met. EVIDENCE: The manager reviewed the statement of purpose and service user’s guide. It was planned to produce these informative documents in video format and make them even more accessible to service users. The file of the newest service user contained a detailed initial assessment and demonstrated that the user, his family social worker and occupational therapist were included in his assessment. The manager and her deputy assessed the user prior to offering him a place. On the example of a blind service user, the home clearly demonstrated how they met the users’ needs. To allow her greater independence and respect her wishes, the home arranged that she wore shoes rather than slippers in the home, thus reducing the risk of tripping. She liked a TV magazine, was buying it herself, and the staff read it to her and other users. She was escorted to the local market to buy her own vegetables and fruit, like she used to do prior to admission. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 9 Staff stated that communication with non-verbal users was effective, as they knew from facial expressions and sounds what they liked, disliked and wanted. On the example of the newest service user, the trial process was appropriate and involved several visits at different times, with family members, so that they could decide themselves on the suitability of the home for them. Contracts in files were copies of social services with Mencap and contained terms and conditions of residency. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9, Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were respected as individuals and choices were promoted, not only through policies, but through the real life actions taken by the home to meet users needs and expectations. EVIDENCE: Two service users files were inspected. They contained care plans that addressed clearly not only their needs, but also their habits and expectations. Care plans were presented in the 1st person making them more individualised. The section on health was presented in picture format. Risk assessments were related to care plans and addressed actions to minimise risks. The occupational therapist took part in the risk assessment for the newest service user. The home kept a separate file with records related to weight monitoring, fluid and food intake, daily records and any relevant chart essential for care of an individual. Restrictions were minimised and bed rails were only used for one user, while another bed rail was replaced by an electric low bed, as it was considered less
Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 11 restrictive but safe enough. A blind service user wanted to stay independent when walking around the home and her wish was met by changing her slippers, which presented a risk of tripping, with shoes that minimised this risk. The manager was not an appointee for any service user regarding their money. The families were involved in users’ financial affairs as users wanted. All but one service users were accompanied to the post office to pay their rent themselves. When quality assurance reviews were carried out, the users received feedback on their comments. They were encouraged to participate in running the home. The plan to produce a statement of purpose in video format would further enhance users’ participation. A case tracked, blind service user was accompanied to the local market to buy fruit and vegetables she liked and wanted. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 12 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users were encouraged to retain and further create the lifestyle they wanted. EVIDENCE: Most service users were not able to participate in mainstream educational or occupational activities, mainly due to their disabilities and age. However, they were encouraged to continue with their activities they exercised prior to admission to the home. A blind service user continued with gardening. Service users were involved in house chores, did shopping with staff and shared the cleaning with staff. One user attended a day centre, but all had a daily programme that involved activities outside the home on weekdays. They were closely connected with their families and were visited, or went to visit them on occasions. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 13 The home employed one male carer offering a better choice to service users of gender related caring tasks, but users in general did not mind the gender of care staff that helped them. There were no restrictions on who service users could to be with and see. The home offered the room keys to all service users, but none of them were able to effectively use them. Staff were observed interacting with service users in the home. A staff member read a TV Times magazine to service users and discussed with them who would do what if they won money from “Who wants to be a millionaire”. “I would buy a lot of grapefruit and celery if I won…”, said the blind service user. By building new docking in the garden the access to it was much improved for service users. There were no restrictions on timing for meals, service users could eat when they wanted. The choice of food was decided on users’ meetings and individually and users also took part in food shopping and preparation of food. Menus demonstrated a balanced and varied diet. One service user had a liquidised diet, and diabetes, that one user suffered from, was controlled by diet. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users’ healthcare needs were well addressed in their files, they had a choice where to register with the local GP and relevant professional were appropriately engaged. EVIDENCE: The home ensured service users were regularly reviewed. Their general healthcare needs were monitored both within the home and by engaging relevant professionals. An occupational therapist was involved and the assessment and outcomes were recorded in files in picture format. The newest service user was offered to remain registered with his GP and allocated a community nurse upon moving to the home. A speech therapist was engaged to help the him. Medication was organised, stored and administered from each house. Records were accurate. There were no service users on prescribed controlled drugs. Creams and ointments were kept in each house in separate cabinets. Allergies to specific substances were recorded and highlighted in records.
Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home had the well developed Mencap complaints procedure that would provide service users, or others involved in their care in the home with a clear path if they wanted to complain. EVIDENCE: The home provided information on how to complain to all relevant people including service users. The standard Mencap complaints procedure was used. It contained timing for investigations and where to proceed with a complaint if the first instance was not effective. The home had not received any complaints since the last inspection. Service users were protected by a clear protection procedure. Staff spoken to were fully aware of the whistle blowing policy. The home kept clear records of incidents/accidents that included verbal outbursts of service users towards staff. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home offered a safe and comfortable environment to service users. EVIDENCE: A tour of the building demonstrated that the premises were kept in good order, well maintained and suitable for the needs of service users. A comment from the blind user described the users’ feelings about the home: “I like it here, it’s not noisy, there is no traffic to disturb us.” Walkie talkies were used by staff to communicate between the two bungalows. The improvements to the environment since the last inspection included: building new decking in the garden, the installation of extractor fans in bathrooms, replacement of patio doors and a raising ramp on the route to garden. The home was bright and clean. Service users were helping with cleaning and maintaining the hygiene in the home.
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The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,35 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home had competent, knowledgeable and trained staff that were able to meet users’ needs. EVIDENCE: The home’s rota showed that sufficient and skilled staff were employed to meet the needs of service users. Two staff in each bungalow at each shift were flexible and helped each other whenever it was needed. The home planned and engaged extra workers when outside activities and outings were planned. The home did not use agency staff and ensured a consistency of service to the users. The effective staff team exceeded standards. The home also exceeded standards relating to NVQ, by having 12 out of 17 staff trained and having 8 staff currently progressing on NVQ programmes at the higher NVQ level. Recruitment was organised following and respecting a strict procedure set by Mencap, and the manager and her deputy were fully involved in the process. All pre-employment checks were carried out prior to offer of employment. Service users had the chance to meet candidates prior to their job interview.
Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 19 The home exceeded standards by following recruitment procedure and checking both with candidates, with staff and with service users the candidates’ suitability for each post. Staff were encouraged to undertake training. The staff member interviewed stated: “I applied for career progression and the company and the management support me. I am doing an NVQ apprenticeship. I know service users well and I am clear of key-working principles. My induction was very good and timed.” The company promoted training and offered much wider training opportunities than just mandatory training. This included Palliative Care, Catheter Care, Person Centred Planning and Dementia. The deputy manager completed physiotherapy training that would have a huge impact on quality of support to service users. The home exceeded this standard. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home ensured that safe working practices were in place and service users benefited from clear safe working procedures. EVIDENCE: The competent, skilled and experienced manager successfully led the staff team to meet the users’ needs. A service user spoken to talked highly of the manager and staff team. The company organised quality assurance reviews and used the findings to further improve services and provisions. The surveys were facilitated by the manager from the other home to ensure better objectivity. The manager noticed that a service user was disturbed by some security questions in the Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 21 survey and re-designed the questionnaire to reduce discomfort for service users. The home implemented safe working policies and procedures to ensure the safety and wellbeing of service users. Staff were regularly and widely trained. Infection control measures were in place and even some service users were aware of the principles. The home was regularly inspected by other regulators, hoists had just been serviced. Risk assessment initiated the ramp and decking change, as well as the installation of extractor fans in bathrooms. Accidents/incidents were accurately recorded. All new staff were inducted on LDAF principles. Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 3 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 4 33 X 34 4 35 4 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43
DS0000015144.V319690.R01.S.doc 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 Score PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Benyon Grove (55-56) Score 3 X 4 X X 3 X
Version 5.2 Page 23 3 3 3 X 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 Benyon Grove (55-56) DS0000015144.V319690.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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