Inspection on 14/09/06 for Blackberry Hill

This inspection was carried out on 14th September 2006.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Blackberry Hill 09/05/08

Blackberry Hill 25/01/06

Blackberry Hill 08/08/05

Blackberry Hill 06/01/05

Blackberry Hill 22/07/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Blackberry Hill Ansford Road Castle Cary Somerset BA7 7HG Lead Inspector John Hurley Key Unannounced Inspection 14th September 2006 09:30 Blackberry Hill DS0000039173.V312048.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 Blackberry Hill DS0000039173.V312048.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. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Blackberry Hill Address Ansford Road Castle Cary Somerset BA7 7HG 01963 350032 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) Home First & Foremost Ltd Mr Shaun Glenn Walker Care Home 10 Category(ies) of Learning disability (10) registration, with number of places Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. One place in Room 7 may be used for a service user with a concurrent physical disability 25th January 2006 Date of last inspection Brief Description of the Service: Blackberry Hill is registered to provide residential services for up to 10 adults within the learning disability category of registration. The Registered Provider is Voyage, Home First & Foremost Ltd. Blackberry Hill opened in April 2003 following extensive refurbishment of the building. The home caters for young service users who have complex needs and a high level of vulnerability. The accommodation is mainly on two floors with additional few steps on the first floor. There is a passenger lift though most service users can use the stairs. Upstairs there are bedrooms and a conservatory lounge. Downstairs there is a dining room, living room and training kitchen; there is also a main kitchen where meals are prepared. Outside there is a parking area to the front of the property with garden areas to the side and back of the house. A previous garage has been converted and equipped to use as a sensory room. This room is also used for some therapies and for arts and crafts. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspector carried out this unannounced inspection over five hours. They viewed all areas of the home and observed the service users who were at home at the time. The inspector spoke with three care staff on duty, the manager and the area manager. The inspector did not have an opportunity to meet with any relatives at the time. Due to the service users limited ability to communicate with the inspector their comments are not recorded in this report. A number of records were examined including a sample of the service users care plans, health and safety records, the corporate vulnerable adults policy, staff rota’s and recent employment records. What the service does well: What has improved since the last inspection? What they could do better: The organisation has changed its procedure on keeping staff checks Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 6 and associated documentation. At the time of the inspection significant information was not available for inspection, the area manager agreed to ensure copies are available at the service for inspection. At the time of the inspection the washing machine had broken down and was awaiting the parts to make it serviceable, the staff had responded by taking washing home. This undermines infection control and so a protocol needs to be drawn up and implemented at times when the laundry facilities are not available, the registered manager acknowledged this. As the home has a long standing history of compliance with the regulations no requirement will be set in relation to this issue. It would be helpful if all activities were risk assessed and cross referenced to the individuals file, including holiday destinations. It would also be helpful if the manager undertook training in the Mental Capacity Act 2005 as the introduction of this new legislation may have an impact on the service offered at Blackberry Hill. 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. Blackberry Hill DS0000039173.V312048.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 Blackberry Hill DS0000039173.V312048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 As there have been no new admissions since the last inspection this group of standards were inspected on the basis of the corporate admissions documentation and stated practice combined with discussions with the staff and a manger. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 9 Comprehensive pre-assessment documents evidence a person centered approach to any new admissions. A manager undertakes an initial consultation with other professionals and considers the assessment of a referring social worker, teachers, parents or other specialists who may be involved. The documentation evidences that the home’s manager and other staff should visit the prospective service user in their home environment or significant other place such as a school, to build a holistic picture of this individual needs. The documentation also states that wherever possible the individual should also attend the home to meet the other service users. Following on from these visits and discussions with the individual, their parents and other interested individuals a draft plan of care will be drawn up and agreed with the individual and their advocates. Blackberry Hill DS0000039173.V312048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,9 The recording and care planning is good and gives the reader informative instructions on the delivery of care on an individual basis. Service users are consulted as much as is reasonably possible. It would be helpful if all activities are risk assessed and cross referenced to the individual, including holiday destinations. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: The inspector briefly sampled the service user individual’s files case tracking two individuals. Each service user has a comprehensive service user plan generated from the assessment information. These plans are reviewed with the service user on a monthly basis. Areas covered included accommodation, health, daily living and communication. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 11 Due to the nature of their disabilities it is not possible for staff to be able to ascertain whether service users understand their individual plans. However, there is good evidence that people important to the service users are involved in, and agree to the objectives of the plans. Feedback from the service users families continue to be supportive of the care provided. Restrictions on freedom of movement were recorded in the service user plans as well as useful risk assessments of a generic nature. It would be useful if some of the generic risk assessments were translated into individual risk assessment. For example there are good risk assessments for the activity, say horse riding, but what could be better evidenced is what this means for the individual who may wish to go horse riding. Not all service users were at the home at the time of the inspection, some had gone on a short break holiday. The manager acknowledged that it would be helpful if the holiday destination and associated itinerary had also been risk assessed and agreed to carry this out in the future. The home continues to use symbols and photographs for some individuals that it is considers find them useful. Staff advised the inspector that intensive interaction courses were available that enabled them to improve their communication skills with residents. In addition to this staff used sign language and their own intuition. Service users records are kept safely in a locked office. The staff were able to demonstrate a good understanding of the rights of the individual and the need for confidentiality. Blackberry Hill DS0000039173.V312048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Opportunities for personal development are only limited through the individuals ability. Service users are given opportunities to develop personally and to take part in age appropriate leisure activities. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: The inspector sampled the records of the home and observed the interactions between the staff and service users as they went about their individual routines. The home continues to display the service users’ artwork in various areas of the home giving it a homely feel. A sample of the records observed demonstrated that the service users engage in a variety of age appropriate leisure activities with their peer groups. These included walks, swimming, music therapy, hydrotherapy, horse riding, Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 13 massage, trampolining, reflexology, bowling, shopping and cinema. Some residents attended a local college. The feedback from relatives showed satisfaction with the services on offer and confirmed that they are consulted as appropriate. The home has a multi sensory room, which service users can enjoy when relaxing at home. During the inspection staff were observed to encourage service user responsibility in a respectful manner. The inspector observed that there were enough food stocks of both fresh and other foods to provide the basis for a nutritious meal. Staff informed the inspector that they were aware of the individuals likes and dislikes and provided that the choices made by the individual ensured a degree of a balanced diet their wishes would be met. Blackberry Hill DS0000039173.V312048.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Service users are well supported and their health needs are met. Medication policies reflect good practice and medication records are accurate. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: The records observed evidence that service users have regular health care checks from the GP and community nurse. They also see other professionals including a psychiatrist, psychologist and physiotherapist. The inspector viewed the relationship between the service users present at the time of the inspection as both empathetic and professional. It was also observed that staff use positive encouragement to gently assist the individual when making choices. At present service users are not able to retain or administer their own medication. The reasons for this are documented in the individuals file. It was noted that the medication records give clear instructions for the use of all medication given via the Per Required Needs route. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 15 All medication is safely locked away in a designated cupboard in the office at the home. The records sampled in relation to the administration of medicines appeared to be accurate. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 16 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): 22,23 The home takes reasonable steps to ensure the safety of the service users through its revised policies and guidelines. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: Some service users, due to the nature of their disabilities, communicate via routes other than speech. Due to this reason it was not possible for the inspector to communicate effectively with these service users. However through discussion with the staff, and through feedback from people important to the service users it is clear that service users were listened to. The inspector noted the staff interactions with service users and found it to be empathetic, meaningful and professional. Staff continue to develop individual forms of communication and appeared to be able to understand individuals needs. Recent events at the home have led to a heightened awareness of abuse issues. These issues have tested the stated policies of the organisation. It is clear that the service follows its stated policy, works well with other organisations in addressing issues and evaluates its own practice as a result of any lessons learned. Service users relatives confirm that they are confident that should concerns arise the organisation will deal with them promptly. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 17 Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 18 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): 24,30 Service users have rooms, which suit their needs within a comfortable and safe environment. The home is clean and hygienic. The registered manager needs to ensure that all infection control policies are robustly applied. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: At the time of the inspection the home was found to be clean and comfortable. The service users rooms are personalised to reflect their individual tastes and preferences. The home has bedrooms on the ground and upper floors. The ground floor is fully accessible to those who require the assistance of a wheelchair. Additional ramps and lifts have been installed to allow a good degree of accessibility to lower floor activity areas. The communal areas are domestic in nature providing comfortable seating and dining facilities. The facilities available for bathing are maintained in good order. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 19 Not all of the laundry facilities were operational at the time of the inspection. The main washing machine had broken down and new parts were waiting to be supplied. The staff had taken some of the service users cloths home to wash in their private facilities. Whilst this further evidences the staff’s commitment to the service users it does undermine infection control policies. The registered manager agreed with the observations and agreed to make alternative arrangements immediately. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 20 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): 32,34,35 The staff team are well trained and knowledgeable with regards to the service users needs and aspirations. The organisation must ensure that employment documentation is available for inspection at all times. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: The registered manager has been in post for a number of years. In general terms they have kept up to date with their own training. However, with the introduction of the Mental Capacity Act 2005 which comes into force in 2007 this will have wide ranging implications for the type of service this home offers.Therefore it is strongly recommended that the registered manager secures training in this important legislation without delay. The inspector asked all staff spoken too about their job description and roles and they were clear on what this entailed. The records sampled confirmed that all staff receive the induction training as well as ongoing training in areas such as food hygiene, first aid, health and safety, manual handling, protection of vulnerable adults and non-violent crisis intervention. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 21 Staff were clear about their roles and responsibilities and were also very complimentary about the management of the home. At the time of the inspection all night care staff were attending a staff meeting. Some of the day staff commented to the inspector that it might be helpful if night care staff occasional carried out a day care duty. These comments were relayed to the management at the time of the inspection. The rotas viewed indicate that there is sufficient staff on duty to meet the service users needs. The inspector was not able to verify if the new staff member’s had under gone all statutory checks as significant information such as references were currently being held at the organisations head office. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 22 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 The home is well managed and this benefits service users and ensures their needs are well met. The environment is safe. Quality in this outcome area is judged to be good. This judgement has been made by evaluating the available evidence and conducting an unannounced visit to this service. EVIDENCE: The inspector viewed a number of key documents during the inspection ranging from care plans to staffing records, these documents were found to be well laid out and in good order. The staff the inspector spoke with said that the manager was approachable and fair, often working with them and the service users. The relationships with other professionals and people important to the service user remain positive and professional. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 23 During the sampling of the staffing records the inspector noted that staff undergo one to one formal supervision on a regular basis. This compliments the ongoing informal supervision that happens on a day-to-day basis. The registered manager and area manager are currently looking at the supervision of the night care staff and have made some alterations to the shift patterns to ensure that at least either the deputy or manager has regular contact with them. The standard of the health and safety documentation is good. Fire maintenance was up to date and fire drills and training had regularly taken place. A fire risk assessment was also in place. Environmental risk assessments were also in place. Wheelchairs were regularly checked and manual handling risk assessments were in place. Staff are aware of infection control and have received training in this. Anti bacterial hand washes are strategically placed around the home. Water temperatures were regularly checked. The inspector examined the COSHH information, which was kept in the health and safety file and found it to be comprehensive. Notices and memos were also displayed in the COSHH cupboard. The statutory health and safety poster is displayed in the office. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 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 3 33 x 34 2 35 3 36 x CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 LIFESTYLES Standard No Score 11 x 12 3 13 3 14 x 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 x 3 x x 3 x Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 25 N0 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 YA34 Regulation 19 Sch 4.6 Requirement The responsible individual must ensure that all records relating to staff applications for employment are available for inspection. Timescale for action 14/09/06 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 YA9 Good Practice Recommendations The registered manager should consider ensuring all risks assessments demonstrate how the individual is being protected from any acknowledged risk. Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Somerset Records Management Unit Ground Floor Riverside Chambers Castle Street Taunton TA1 4AL 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 Blackberry Hill DS0000039173.V312048.R01.S.doc Version 5.2 Page 27 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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