Inspection on 25/01/06 for Blackberry Hill

This inspection was carried out on 25th January 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 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

Blackberry Hill 09/05/08

Blackberry Hill 14/09/06

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 Debbi Flint Unannounced Inspection 25 January 2006 11:30 th Blackberry Hill DS0000039173.V279725.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 Blackberry Hill DS0000039173.V279725.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. Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 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.V279725.R01.S.doc Version 5.1 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. 8th August 2005 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.V279725.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection carried out over three and a half hours by one inspector. The manager facilitated the inspection. All of the eight service users currently resident were present at some point during the inspection and the inspector was able to meet with them but due to the nature of their disabilities the inspector was not able to communicate with them at length and they were not able to make comments for the purpose of this report. Communication with the service users is a long-term process which staff have developed through knowledge of each individual and their body language /speech and through the use of sign language. On the day of the inspection there were three staff on duty (not including the Manager) in the morning and four staff on duty in the afternoon. The inspector spoke in detail with the four afternoon staff. A physiotherapist visited in the afternoon and the inspector also spoke with her. A number of records were examined including service users care files, health and safety records, supervision records, the communication book and medication records. What the service does well: What has improved since the last inspection? The requirement from the previous inspection that all service users documentation give clear instruction for the use of PRN had been met. A requirement that the manager ensure that service users accounts accurately reflect all debits and credits made to the accounts had also been met. Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 6 A recommendation that the organisation consider how it supports staff who are undergoing national vocational training had also been met. 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. Blackberry Hill DS0000039173.V279725.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 Blackberry Hill DS0000039173.V279725.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): As there were no new admissions since the last inspection it was not possible to assess these standards. It is noted that the home met this group of standards when a service user was last admitted. EVIDENCE: Blackberry Hill DS0000039173.V279725.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, 8, 9 & 10 Staff make every effort to consult service users as much as is reasonably possible. Service users are supported to take risks as much as is reasonably possible. Confidentiality is maintained. EVIDENCE: 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 the inspector examined a random selection of individual plans and found that on some of them attempts had been made to make them person friendly. Symbols and photographs were used for some clients. It would be helpful if the home were to develop person friendly plans for all clients. All care plans examined were comprehensive and included care needs, objectives and action required. Areas covered included accommodation, health, daily living and communication. Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 10 The inspector asked staff how they ensured service users were consulted about their lives, their personal wishes and life in the home. 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 personal intuition. The home has a stable staff team and staff have got to know the residents. The inspector examined a random selection of client risk assessments and saw that there was appropriate guidance in place to enable the residents to participate in activities safely. Due to the nature of their disabilities it is unlikely that any of the residents will ever be able to achieve complete independence. Service users records are kept safely in a locked office. Blackberry Hill DS0000039173.V279725.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): 11, 12, 14 & 16 Service users are given opportunities to develop personally and to take part in age appropriate leisure activities. Service users are respected and encouraged to develop independence. EVIDENCE: The inspector toured the home and saw that residents’ artwork was displayed in various communal areas and in the bedrooms of some service users. The home has a trainer kitchen in addition to the kitchen used by staff to cook everyday meals. The trainer kitchen is used by residents to learn cooking skills according to their ability and they are assisted by staff in this enterprise. Records showed that residents engaged in a variety of age appropriate leisure activities with their peer groups. These included walks, swimming, music therapy, hydrotherapy, horse riding, massage, trampolining, reflexology, bowling, shopping and cinema. Some residents attended a local college. The home has a multi sensory room, which service users can enjoy when relaxing Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 12 at home. The day of the inspection staff were observed to encourage service user responsibility in a respectful manner. Blackberry Hill DS0000039173.V279725.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, 20 Service users are well supported and their health needs are met. Medication policies reflect good practice and medication records are accurate. EVIDENCE: On the day of the inspection a physiotherapist visited the home and she explained to the inspector that her role was to give personal support to those who needed help with their mobility. The inspector noted from records that music therapists and reflexologists also visited the home on a regular basis. The inspector examined individual files and found care plans to be comprehensive. Care needs, objectives and action required was detailed. Areas covered included accommodation, health, daily living and communication. Health plans were detailed and service users have regular checks from their G.P. and a community nurse. Optical and dental needs were also met. At present service users are not able to retain or administer their own medication. The reasons for this are documented in the individuals file. The inspector examined the medication records and found them to be accurate. Medication is kept in a locked cupboard within the office. At the previous Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 14 inspection a requirement had been made that all service users documentation should give clear instructions for the use of all medication given via the PRN route. This requirement had been met and there were clear instructions in place for all PRN medication; however the inspector noted that none of the instructions were dated. No formal recommendation was made as the manager actioned this immediately. Blackberry Hill DS0000039173.V279725.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 & 23 Service users are listened to. Service users are well protected by staff within the home. 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 with these service users effectively however the inspector spoke to staff and was satisfied that service users were listened to. The inspector also observed staff interactions with service users and found it to be empathetic, meaningful and professional. Staff had developed individual forms of communication with each resident and were able to understand the individuals needs. No complaints had been made to the home but the inspector examined the vulnerable adults policy and found it to be comprehensive. All staff receive training in protecting vulnerable adults as part of their induction. Blackberry Hill DS0000039173.V279725.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, 25 & 30 Service users have rooms, which suit their needs within a comfortable and safe environment. The home is clean and hygienic. EVIDENCE: The inspector toured the home and found it to be clean, homely and comfortable. Several service users were relaxing in their rooms with the door open and although the inspector did not enter their rooms she was able to note that the residents had a variety of aids and sensory equipment to meet their needs. One service user was able to give permission for the inspector to enter her room and the inspector saw that she had a personal notice board and her own art work and personal photos were displayed. The resident had a TV, DVD and video. Her room was en-suite. Blackberry Hill DS0000039173.V279725.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): 31, 32, 33 & 36 Service users are well supported by competent staff that work well together as a team. The level of staff support has increased but can further improve. Staff are clear about their responsibilities. EVIDENCE: The inspector examined the staff supervision log and noted that staff had not received supervision in accordance with NMS 36 in the past year. The current manager had not yet been in post for a year and the inspector recommended he build on his current efforts to increase the frequency of staff supervision. Staff spoken with all stated that the level of support had increased since the current manager had taken charge. The inspector spoke with four members of staff and they all stated that they had received essential training in food hygiene, first aid, health and safety, manual handling, protection of vulnerable adults and non-violent crisis intervention. Staff were clear about their roles and responsibilities and were also very complimentary about the management of the home. One staff member said, ”We are like one big happy family. There is a great staff team and a fantastic manager. We all do our best to make sure the residents are well supported.” Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 18 The inspector asked all staff spoken with about their job description and roles and they were clear on what this entailed. At the previous inspection a recommendation had been made that the organisation needed to consider how it supported staff who were undergoing national vocational training. At this inspection all staff stated they felt well supported. Over 50 percent of staff either had NVQ 2 or 3 or were working towards it. Blackberry Hill DS0000039173.V279725.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, 38 & 42 The home is well managed and this benefits service users and ensures their needs are well met. The environment is safe. EVIDENCE: All staff spoken with stated that they believed the home to be well-managed and service users’ needs to be well met. Service users were observed to be happy and comfortable in the home. At the previous inspection a requirement had been made that all service users’ individual accounts accurately reflect all debits and credits made to the accounts. The inspector examined a random selection of service users accounts and saw that this requirement had been met. All staff spoken with felt that the leadership of the home was excellent. Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 20 Health and safety was good. Fire maintenance was up to date and fire drills and training had regularly taken place. A fire risk assessment was also in place. All residents had comprehensive personal risk assessments, which looked at key health and safety issues such as epilepsy and choking. Environmental risk assessments were also in place. Wheelchairs were regularly checked and manual handling risk assessments were in place. Staff were aware of infection control and received training in this. Anti bacterial hand washes were 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. The inspector observed that files stored in the office were placed on shelves above the head of anyone using the desk. These files were not fully secure and on one occasion a file fell off the shelf. A recommendation was made that the shelves be made safe to prevent the risk of files falling on the head of anyone using the office. Blackberry Hill DS0000039173.V279725.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 CHOICE OF HOME Standard No Score 1 X 2 X 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 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 X 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 X 14 3 15 X 16 3 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 X X X 3 X Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 22 Are there any outstanding requirements from the last inspection? No 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. 1 2 Refer to Standard YA36 YA42 Good Practice Recommendations Staff should receive formal supervision on at least six occasions during the year. Shelves in the office should be made safe to prevent the risk of files falling. Blackberry Hill DS0000039173.V279725.R01.S.doc Version 5.1 Page 23 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.V279725.R01.S.doc Version 5.1 Page 24 - 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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