Inspection on 10/05/06 for Blakesley House

This inspection was carried out on 10th May 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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

Blakesley House 25/11/05

Blakesley House 21/06/05

Similar services:

Hillside

Applegarth

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

Hunter`s Lodge

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

CARE HOME ADULTS 18-65 Blakesley House Blakesley House 2 High Street Blakesley Towcester Northants NN12 8RE Lead Inspector Judith Roan Unannounced Inspection 10th May 2006 14:00 Blakesley House DS0000062174.V294197.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 Blakesley House DS0000062174.V294197.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. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Blakesley House Address 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) Blakesley House 2 High Street Blakesley Towcester Northants NN12 8RE 01327 860412 William Blake House Mr Clive William John Denby Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The home will restrict its services to people within the Learning Disability (LD) category. The total number of services users in the home must not exceed 3. Service users must be between the ages of 18 - 65 years Date of last inspection 25th November 2005 Brief Description of the Service: Blakesley House is part of a group of houses managed by William Blake House based on a shared community. 2 High Street is a large family house that provides accommodation for three service users. The house managers their family and co-workers also live at the house. Blakesley is a small village close to Greens Norton and 5 miles from the small rural town of Towcester. The house is on three floors and has a large family kitchen with a separate dining room and lounge that is split-level. All service users have individual bedrooms that are located on both ground and first floor. There is access to a range of bathing facilities within the home that meet service users needs. Adjoining the house is a large meeting room that is used for activities and community meetings. Fee levels range from £1766 to £2230 Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of their records, discussion with them, the co-workers and observation of care practices. The inspector also spent time with the house manager and met members of the executive that were meeting at the house. The Inspector also received a pre-inspection questionnaire completed by the homes manager and comment cards from relatives. All questionnaires provided very positive feedback of the quality of care and service. The inspection involved the completion of an inspection record that is produced from reviewing information received by the Commission since the last inspection, and case tracking during the inspection that took place over a period of 6 hours. What the service does well: The home provides continuous assessment of service users needs. Co-workers are very knowledgeable about service users needs. Health care needs are monitored and appropriate action is taken. Service users have a range of daily activities of their choice. Service users are supported to be included within the community and have built a positive relationship with others in the surrounding area. Photographic evidence is used in some areas of the homes work to demonstrate how service users are supported with activities within the home and in the community. The home is maintained to a high standard and service users have access to individual rooms that reflect their personal preferences. Communal areas enable a range of activities to be undertaken within a family setting. The co-workers show a high level of commitment to the work and bring a range of skills to support service users. Good management ensures that service users are met and co-workers are trained and supervised. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 6 The home has strong leadership that encourages service user, co-worker and family reflection on the service provided. What has improved since the last inspection? 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. Blakesley House DS0000062174.V294197.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 Blakesley House DS0000062174.V294197.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): 1,2,3,4,5 Quality in this outcome area is excellent. The admission process ensures that needs are assessed and that service users are fully involved within the process. This judgement has been made using available evidence including a visit to the service. EVIDENCE: All of the service users living at Blakesley House have lived at the home since it was opened. It is evident from case records that a through assessment of need was undertaken by the homes manager at the time of admission to ensure that individual needs could be met. The admission process entails the registered manager and members of the coworker group spending time with the service user, their family, gathering detailed information from previous placement and the funding authority. Files contain good information that has been gathered as part of the assessment process. This information is updated with ongoing work especially in relation to health care needs. Service users needs are continually assessed and changes to needs and how these are to be met are shared at dedicated forums undertaken within the home. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 9 Service users files hold contracts made with the funding authorities and the home. Due to service users having complex needs and difficulties with communication contracts have been put in place between home and their families as part of good practice. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 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): 6,7,8,9 Quality in this outcome area is good. Service users can expect that practices within the home promote their involvement and independence. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Care plans are now in place for service users and are reviewed as required. An annual review is undertaken with the funding authority. Regular forums in which care needs of individual service users are reviewed ensure that there is continuous development. If there is a sudden change in need further meetings of co-workers are called to consider strategies to meet the need. In discussion with the house manager the issue of making daily recordings of care undertaken was discussed. They will look at options with the registered manager. It must be stressed that outcomes for service users are positive and that needs are being met within the systems in place at the home. In discussion with coworkers it was evident they are very knowledgeable about the needs of service users. A co-worker informed the inspector that they had worked alongside Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 11 another experienced worker until they has demonstrated that they were competent and confident in meeting the service users needs. Feedback from families all confirmed that they pleased with how their son or daughter was being supported. Support for service users enables them to develop their skills and participate in everyday activities that they previously were not able to achieve. Learning is achieved by the consistent approaches used by co-workers and service users having access to and observing a broad spectrum of daily living activities. Risks within activities are considered on an individual basis and plans made to minimise these for each service user. Service users are encouraged to be as independent as possible with appropriate support. In this way service users are included within activities and not excluded because of any behaviour that may arise. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 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): 11,12,13,14,15,16,17 Quality in this outcome area is excellent. Planned intervention enables and supports service users to develop personal skills and take opportunities for social and community activities. Practices respect service users rights and encourage individual and joint responsibility in the management of the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The inspector was shown a computer record of photographs showing service users within different activities. A weekly activities programme is available that is often updated to take into account of seasonal events, religious festivals and wishes of service users. New activities are tried out to extend the choices and experiences for service users. It was noted in one file that a service user who had not flown before was supported to take a short flight in preparation for their summer holiday. Careful planning is undertaken for all activities to ensure that service users and co-workers are protected and enjoy the experience. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 13 Experiences for service users remain good and varied. Service users are fully involved with day-to-day living tasks within the home. All of the service users were at home and had just finished clearing away from lunch. The planned activity for the afternoon was a walk. The inspector accompanied service users and co-workers to observe how support was provided on a community activity. As it was a fine and sunny day co-workers ensured that service users were protected from sun damage by creams and the wearing of hats. Service users remain involved with the recycling project and have other various work and leisure options within the week. Throughout the inspection the inspector observed positive work with service users using strategies noted within the care plans in supporting people with behaviours that challenge. The teatime meal was freshly cooked by co-workers involving services appropriately. Co-workers have a good understanding of health care needs for service users and give full attention throughout the meal. The meal served looked appetising and healthy. The standard of food prepared at the home remains high being produced from fresh, seasonal and local produce. A food diary is kept to ensure that a balanced diet is provided. Feedback within the questionnaires from family members about the service provided was very good. Families commented on how good the communication has been with them and that the registered manager and the team of co-workers always kept them informed. The files supported this fact and contained numerous letters to families to inform them of forthcoming events. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 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): Quality in this outcome area is excellent. Service users’ physical and emotional health needs are met. A trained staff team ensures that service users are well supported in meeting their physical and mental well being. Medications systems within the home are robust and protect service users. This judgement has been made using available evidence including a visit to the service. EVIDENCE: Service users are supported to have regular health checks and there is evidence on files that GP, specialist, dentist and optician appointments are made. Again it was not possible to see an overview of how appointments were managed, as a daily recording system is not available. A recommendation is made for the Registered manager to review the homes recording system to improve practice in this area. Personal support is provided in a discreet manner and with service users preferences being a top priority. There are always sufficient male and female co-workers on duty to provide gender appropriate support. Medical profiles for service users have clear information given by the Homeopathic doctor about its benefits and how it is used. Notes were also available from the doctor after his visits, with a review of current homeopathic Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 15 medication. The files also contained background information on specific medical condition that aided the co-workers understanding of the service users needs. The home has a good medication recording system that demonstrates the path of medication coming into the home with safe administration and disposal. It was noted on one file that the local GP practice had written and commended the service at Blakesley House stating ‘ I feel the service user is well looked after at the William Blake House in Blakesely, that the environment will be most beneficial’ All incidents are recorded on file to show how co-workers have reviewed practice to minimise future risks. One file had a recorded incident form that had not been notified to the Commission. This was an oversight as the Registered Manager is normally very thorough in keeping the lead inspector informed of events within the home. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 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 Quality in this outcome area is excellent. Service users are protected by abuse awareness policies and practices within the home. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home has comprehensive policies and procedures in relation to handling concerns and complaints made. As the service users group has limited communication staff are trained to observe changes in behaviour that may indicate that a service user is unhappy with the support they receive. Coworkers undertake abuse awareness training as part of their induction/ foundation training. The inspector was able to check out their understanding during the inspection. The questionnaires completed by families gave positive feedback about the support and were fully aware of the complaints policy and procedures if they needed to express a concern. The open approach of the registered manager enables families to feel comfortable if there was a need to make a complaint or express a concern. There have been no complaints since the last inspection. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 17 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): 24,25,26,27,28,30 Quality in this outcome area is excellent. The home is maintained to a high standard, providing a warm and relaxed environment with good personal and communal space. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The home is shared with co-workers and family members. There are adequate rooms to enable everyone to have their own personal space in the large converted dwelling. Service user rooms are personalised, comfortable and well maintained. Service users are supported in maintaining their rooms to a high standard of cleanliness and safety. The home is well maintained and decorated to a high standard. There is a family size kitchen that is large enough for service users to assist or sit comfortably and be part of meal preparations. The communal space provides for service users to undertake a range of activities with co-workers in the main house. The present laundry area in the separate community activity room is to be relocated to an outhouse that is to be converted. The community room enables service users to meet and join in Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 18 with others from the William Blake House group of services. The room is also used to hold forum meetings and special events throughout the year. The garden is to be developed to provide areas for relaxation and the growing of their own produce. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 19 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): 32,33,34,35,36 Quality in this outcome area is excellent. The trained, competent and supported staff team ensure that the service is professional and meets identified service user needs. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The core of co-workers consists of two house managers and a team of coworkers working on contracted placements through community service volunteers (CSV) that also co-ordinate volunteers from overseas. Since the last inspection co-workers have developed skills and knowledge in supporting service users need through induction and core training. New co-workers undertake an induction and work alongside an experienced member of the team to gain full knowledge about the needs of all the service users that live at the home. Co-workers confirmed that they shadowed an experienced worker until they were competent and confident in providing the level of support required. Prior to co-workers arrival CSV undertake extensive checks on volunteers. CSV have confirmed that references are taken up by their organisation as part of the screening process. All overseas volunteers have a police check as part of the CSV application when they apply in their country. Criminal Records Bureau checks (CRB) are undertaken on arrival. The records confirm this to be the procedure followed in the entire William Blake House group. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 20 Co-workers are offered a range of opportunities to train. The house manager has commenced the National Vocational Qualification (NVQ) level four in care and the registered managers award (RMA) as part of developing a senior management structure. The registered manager already holds the NVQ Level four and the RMA. Co-workers have a ‘Memorandum of Understanding’ that they sign jointly with the manager that sets out their responsibilities and role within the William Blake House organisation. Supervision is done at two levels one directly with the house manager that discusses a co-workers role with service users and the service provided and one with an external consultant. Supervision levels at the home exceed the national minimum standards All co-workers and the house managers meet with the consultant to look at issues of living and working within the community. As the consultant was undertaking supervision on the day of the visit the inspector was able to meet with and discuss how their role enabled and benefited the work at the home. In addition to supervision all co-workers are part of forums that discuss a range of work areas to enable the service to run more effectively. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 21 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): 37,38,39,42 Quality in this outcome area is good. The home is effectively managed and ensures that service users receive a quality service where their views are respected and their safety is safeguarded. This judgement has been made using available evidence including a visit to the service. EVIDENCE: The Registered Manager and the house maanger effectively manage the home in the best interests of service users and co-workers. A number of groups ensure the effective running of the service across the four homes. Co-workers and service users are part of the groups that have various roles as follows: Organisations – diary, visitors, cover of shifts and holidays Specialist – Medical, primary health care, spiritual guidance, supervision Welcome – reception group for new co-workers Work projects -activities and work placements Resources – maintenance of houses Prep – for Management meeting and directors Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 22 Environmental – how to help the environment Policy – development and review of organisational policies Finance – budgets and training Therapy – use of therapies and their effectiveness In addition to the focus groups the home continues with internal meetings like house and co-worker meetings that provide for a regular review of service users needs. The registered manager and responsible individual are developing a quality assurance system that is service users centred and is used to inform management on how to develop the service in their best interests. The inspector was shown a newly prepared computer record using the power point program that had been used as a visual presentation to parents and a recent meeting. The lack of daily recording does not fully protect service users and the inspector discussed with the house manager how this area could be improved. The home has undertaken all health and safety checks required. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 23 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 4 2 4 3 4 4 4 5 4 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 4 25 4 26 4 27 4 28 4 29 X 30 4 STAFFING Standard No Score 31 4 32 3 33 4 34 3 35 4 36 4 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 2 LIFESTYLES Standard No Score 11 4 12 4 13 4 14 4 15 4 16 4 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 4 X 4 4 3 X 2 4 x Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 24 Are there any outstanding requirements from the last inspection? N/A 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 YA10 YA41 Good Practice Recommendations A review of how Service user files are stored needs to be undertaken by the Registered Manager to meet this standard. The home needs to review how they maintain records to provide evidence on how this standard is met. Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB 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 Blakesley House DS0000062174.V294197.R01.S.doc Version 5.1 Page 26 - 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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