Inspection on 28/08/05 for Berrywood

This inspection was carried out on 28th August 2005.

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 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

Berrywood 08/12/06

Berrywood 30/01/06

Berrywood 22/03/05

Berrywood 06/09/04

Berrywood 11/03/04

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Paradise Lodge

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Upaya Ananda

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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 Berrywood 130 Berry Lane Rickmansworth Hertfordshire WD3 4BT Lead Inspector Claire Farrier Unannounced 28 August 2005 at 8:20 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Berrywood Address 130 Berry Lane Rickmansworth Hertfordshire WD3 4BT 01923 770132 01923 770132 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Watford and District Mencap Care Home 5 Category(ies) of LD Learning Disability - 5 registration, with number LD(E) Learning Disability (over 65) - 5 of places PD(E) Physical Disability (over 65) - 5 Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: This home may accommodate 1 person with physical disability (aged over 65 years) Date of last inspection 22 March 2005 Brief Description of the Service: Berrywood is a care home providing personal care and accommodation for five people with learning disabilities, one of whom may also have a physical disability. It is owned by Watford and District MENCAP, which is a voluntary organisation. The home was opened in 1991 and consists of a two storey semidetached house, which is indistinguishable from the neighbouring properties. The home is situated in a residential area of Rickmansworth, within walking distance of local shops and on a bus route for access to the town centre.All the home’s bedrooms are single and one has a wheelchair accessible en-suite bathroom. The home has a large garden that is easily accessible for all service users. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place on a Sunday, starting at 8.20 in the morning. The home is registered for five residents, but there are currently three vacancies, and one resident is in hospital. The early start to the inspection was to ensure that the remaining resident was seen before going out for any daily activities. The majority of time was spent observing and talking to the residents and member of staff on duty. Some time was also spent looking at care plans, and records. The resident and staff were very welcoming, despite the early start. This was generally a positive inspection, and the majority of the standards were met. A requirement was made concerning bad staining on the bathroom floor and bath hoist. What the service does well: What has improved since the last inspection? The new format for care plans (see above) now provides clearly written and accessible information on the residents’ needs. The one resident currently living in the home is enjoying the one-to-one attention that she receives, and her care plan records improvements seen in her behaviour. All residents have one-to-one time (My Time) with their key worker on a regular basis, and the records of these sessions show that they are now much more involved in choices and decisions about their lives in the home. The atmosphere of the home is now that it is the home of the residents, with the staff there to support and assist them, instead of making decisions for them. This may be partly due to the current low number of residents, but discussion with the resident and member of staff indicated that there has been a change in ethos in the home. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 6 Most of the requirements made in the last inspection report have been met. However, due to the absence of the acting manager on this occasion it was not possible to see evidence that the requirements concerning staff records and quality assurance have been met, and these requirements have therefore been carried forward to this report. The response to the last report stated that Watford and District Mencap will set up a quality assurance system for all homes by the end of August 2005. 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. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 2 and 5 The home has sufficient information on residents’ needs and access to appropriate services to enable their needs to be met. EVIDENCE: The home has only two residents of whom one is in hospital, and no new admissions have taken place since the last inspection. The file of the remaining resident contained a thorough CPA (Care Programme Approach) report, with full details of all her needs and how they should be met. The resident’s file contained a copy of the home’s licence agreement. It is written in plain English and signed by the resident. However it is not available in a format that can be understood by residents who are unable to read, and it does not specify the room to be occupied or the fees charged. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6, 7 and 9 The residents’ care plans contain detailed information on all their personal care and health care needs, which enable the staff to provide a good quality of care. The staff were observed to treat the residents with respect and to assist them to make choices about their lives. Risk assessments are in place for the home and for individual residents, but they need to be reviewed and updated to ensure that residents are protected from avoidable hazards. EVIDENCE: The files for both the current residents were inspected, and care provided for them was assessed through the process of case tracking, which showed what care is provided for the residents and how it is recorded. The format of the care plans has improved, and they are now well written, and contain all the information required to assist the staff to provide appropriate care and support. Full details are included of personal information, and health and social care needs, and detailed procedures are in place, for example for meal times for one resident, with reference given to appropriate risk assessments. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 10 It was reported that the care plans are discussed with the residents, but there is no indication of their involvement. The format could provide a basis for a person centred planning (PCP) approach, which should focus on the person being totally at the centre of all planning, and the key workers could assist and enable residents to write and monitor their own monthly objectives. Current risk assessments are in place for individual residents, including well written risk assessments for behaviour management. The risk assessments include an action plan to reduce the behaviour. Generic risk assessments for the home are stored in a separate file. The latest assessment seen was dated in March 2004, but there was no indication of any reviews. The risk assessment file also includes risk assessments for individual residents, but there is no indication whether these are current, and several risk assessments were seen for residents who no longer live in the home. The risk assessments in this file for the current residents include activities such as hair washing and getting dressed, for which there is no recorded risk in the care plan. These were also all written in March 2004 and have not been reviewed since that time. Many of these have been superseded by the improved risk assessments referred to above, but there is no indication that they are no longer current, which in some circumstances could lead to dangerous practice. Each resident has one-to-one time with their key worker each month, when they discuss what they would like to do and how they will achieve it. At one session a resident had said that they would like to go to the cinema and the theatre, and during the next session it was recorded that two visits to the cinema had taken place. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 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 standard(s) 12, 13, 14, 16 and 17 The residents are encouraged to make choices for their activities, and to be involved according to their abilities in developing their skills for independence. Personal development opportunities are encouraged for all residents ensuring good relationships with their families and with the local community, and that individual rights and responsibilities are recognised and supported. EVIDENCE: The home’s only current resident (one is in hospital) said that she attends the day centre from Monday to Friday. The inspection took place on a Sunday, and she was still asleep when the inspector arrived. When she got up she said that she planned to spend the day catching up on Eastenders on TV. She has a befriender from Guideposts, and they go out together once a fortnight. Her care plan recorded that she has been to the cinema, the theatre, for meals out and shopping and to the hairdresser. The member of staff on duty explained that Berrrywood is the residents’ home, and the staff encourage them to do as much as possible for themselves. The resident in the home spent some of the morning tidying her room. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 12 She chooses her own meals, with the help of a visual menu book, and prepares her own lunch to take to the day centre. The staff suggest changes to her so that she doesn’t get bored with the same food every day. The menus show a good variety of meals provided, and fresh food is available for preparing healthy meals. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 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 standard(s) 18, 19 and 20 The staff provide good quality personal care and treat the residents with sensitivity and respect. There is good recording of all the residents’ health care needs. All personal and health care support is well maintained within the home ensuring that individual needs, choices and preferences are met at all times. The procedures for administering and recording medication are followed appropriately. EVIDENCE: The care plans that were inspected provide comprehensive details of the residents’ personal care and health care needs (see Standard 6), and a good relationship was observed between the staff and the resident. Appropriate behaviour guidelines were seen, and the staff follow these sensitively, encouraging appropriate behaviour without seeming to impose rules on the residents. Detailed recording of each resident’s health care includes health notes for hospital visits and contact with GPs and other medical professionals. One resident is currently in hospital, and his care plan showed good recording of the deterioration that led to the hospital admission, and the actions taken. Each resident has an individual medication cabinet in their bedroom. Medication is dispensed from Nomad monitored dosage boxes, and recorded appropriately. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 23 Procedures are in place to ensure that people living in the home are protected from abuse. EVIDENCE: Following the last inspection, adult protection guidelines have been put in place. The procedure for prevention of abuse is clearly written, and relates to the local authority procedures. The whistle blowing policy details the rights and responsibilities of staff, but does not include contact details for appropriate outside bodies that can be contacted with any concerns. These should include Social Services and CSCI. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 and 30 The home provides a comfortable and well maintained environment for the residents, and the staff maintain a good standard of cleanliness and hygiene. EVIDENCE: Berrywood is a two storey semi-detached house, which is indistinguishable from its neighbouring properties. The home is situated in a residential area of Rickmansworth, within walking distance of local shops and on a bus route for access to the town centre. There is a large garden that is easily accessible for the residents. The home appeared to be clean and well maintained. Staff spoken to confirmed that they follow the policies and procedures for maintenance of hygiene and control of infection. However in the first floor bathroom, which is used by the current residents, there are black marks and staining on the floor and on the seat of the static bath hoist which should be addressed. If the floor and equipment cannot be cleaned effectively, replacements must be provided. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33 The home is staffed by experienced support workers in sufficient numbers to meet the needs of the current residents. The staff spoken to are confident of their knowledge of the needs of the residents and feel well supported in their work. EVIDENCE: The home has only two residents, of whom one is currently in hospital. The staffing complement has been maintained, and there is one member of staff in the home at all times, who knows the single resident well. The other staff spend some of their time at another Watford and District Mencap home. The member of staff who was in the home during the inspection had slept there the previous night. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 42 The home maintains appropriate records for the health and safety of the residents and staff in the home, and staff follow the home’s policies and procedures. EVIDENCE: All the records required for maintenance of health and safety in the home are complete and up to date. Accidents and incidents are recorded appropriately. Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. 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 2 Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 x 2 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x 3 Standard No 11 12 13 14 15 16 17 x 3 3 3 3 3 3 Standard No 31 32 33 34 35 36 Score x x 3 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Berrywood Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x 3 x I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 19 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 24 Regulation Requirement Timescale for action 31 December 2005 31 May 2005 2. 34 3. 39 23(2)(c) & The flloring and bath hoist in the (d) bathroom were badly stained. If the floor and equipment cannot be cleaned effectively, they must be replaced. 19(1) All required information for each Schedule member of staff must be kept in the home, including evidence of 2 and 17(2) a satisfactory CRB check. Schedule This standard was not inspected 4(6) on this occasion, and the requirement has therefore been repeated. 24 A system for monitoring the quality of care must be established, that focuses on the consultation with the service users and other involved people, and provides feedback on the process and the results of the consultation. This standard was not inspected on this occasion, and the requirement has therefore been repeated. 31 August 2005 Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 20 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 5 Good Practice Recommendations The homes licence agreement should be produced in a format that can be understood by the residents. It should also contain all the information specified in Standard 5, and in particular the rrom to be occupied and the fees charged for each resident. The care plans contain comprehensive information on all aspects of the residents life, but there is no evidence that the residents are involvd in writing and reviewing their care plans, in line with PCP. It is recommended that the staff should encourage and enable reidents to provide a realistic input into their care plans and reviews, for example by setting their own targets or monitoring their own progress. The homes generic and individual risk assessments have not been reviewed since they were written and many are no longer relevant. The risk asessments should be reviewed and updated to ensure that they provide current and accurate information. The whistle blowing policy should be amended to include the contact details of outside bodies, including Social Services and CSCI. 2. 6 3. 9 4. 23 Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection Mercury House 1 Broadwater Road Welwyn Garden City AL7 3BQ 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 Berrywood I52 s19290 berrywood v247377 280805 stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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