Inspection on 21/06/05 for Blakesley House

This inspection was carried out on 21st June 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

Blakesley House 10/05/06

Blakesley House 25/11/05

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 Blakesely House 2 High Street Blakesley Towcester NN12 8RE Lead Inspector Judith Roan Unannounced 21 June 2005 @ 15:50 st 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. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Blakesley House Address 2 High Street Blakesley House Towcester NN12 8RE 01327 860412 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) William Blake House Mr Clive Denby Care Home 3 Category(ies) of LD Learning Disability registration, with number of places Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 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 First inspection after registration Brief Description of the Service: 2 High Street is a large family house that provides accomodation 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 two floors and has a large family kitchen with a separate dining room and lounge that are split level. All service users have an individual bedroom which 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..i Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for Service Users and their views of the service provided. The primary method of inspection used was ‘case tracking’ which involved selecting 3 residents and tracking the care they receive through review of their records, discussion with co workers and observation of care practices. The service users were happy to show the inspector around their home. The inspection took place during the afternoon and early evening, over a period of 3.5 hours and was carried out on an unannounced basis. What the service does well: The service has a good assessment process for identifying the needs of service users who are considering moving to the service. This assessment informs co-workers in developing a care plan that underpins the work undertaken. The knowledge of co-workers about the needs of service users is good. There is excellent communication between co-workers, the service users and families. Service users are fully involved with the making of decisions about their lifestyle and are supported to develop skills to increase their independence within a supported environment. Community involvement through work placements and participation in every day activities is excellent. Health care needs are monitored with full participation of the service users and their families. The homes philosophy enables service to access the use of the local primary health care services and a homeopathic doctor. The accommodation is of a high standard and provides individual space for service users and co-workers. There is a high standard of maintenance and service users choose how their own bedrooms are decorated and arranged. The level of co-workers supporting service users is on a 1-1 basis. The team of co-workers are well supported by the management structure and an independent supervisory consultant. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 6 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. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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) 1, 2, 3, 4 and 5 Information available and the opportunity to visit and stay at the home prior to admission enables service users to have an informed choice about the service. EVIDENCE: The home has a statement of purpose and service user guide that clearly set out the service provided at the home. The files viewed demonstrated that detailed assessments are undertaken by the funding authority and the home. Service user visit the home prior to admission and then they can have a trial visit to establish their views on whether they would like to remain at the home. During this time reviews the service users, families and funding authorities take place. A contract setting out the terms of the placement is drawn up between the service user and home. During the trial visit co-workers document activities using photographs so that the service users has a point of reference when discussing the visits and making the decision to move to the home. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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, 8 and 9 Service users are involved within their ability to develop their care plans, make decisions and have a lifestyle where they are supported to take risks to be more independent. EVIDENCE: Using the details from the assessments and trial visits care plans are complied with the service user input. Service users at 2 High St have limited communication, however the inspector was able to observe how co-workers consult with and enable individuals to make decisions about the support they need. Care plans set out clearly the support each service users requires. The house manager informed the inspector that they were developing the service users files to make information easier to access. Co-workers were able to inform the inspector that service users were supported to carry out everyday activities within the home, like cleaning laundry and clearing and washing up after meals. Risk assessments are developed and documented around the activities that individuals undertake. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 10 Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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) 11, 12, 13, 14, 15,.16 and 17 The development of personal goals and the wide range of supported work, leisure and community options avaialble enhance the lifestyle for Service users. EVIDENCE: Since service users were admitted into the home they have been supported to develop daily living skills by participation in household activities. Each service users is supported within various work placements in the local area and coworkers are considering plans with service users to extend the options. Service users have the option to use a local health resort for exercise and relaxation. The inspector was able to see part of the work undertaken by service users of the community re-cycling scheme that enable them to be part of and give something of themselves to the community. A holiday trip to Iceland this year is arranged for early July with other William Blake homes. All service users and volunteers will be attending. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 12 It was clear from the files viewed that plans and detailed arrangements had been made to make the travel arrangements run smoothly. Records demonstrate there is regular contact with family members, keeping them informed about developments and care issues. Family members are welcome and visit the home regularly. A member of staff confirmed that service users helped with the domestic shopping and were fully involved with choosing the menus. Shared meals with other homes within the William Blake House group are a positive feature giving an opportunity for individuals to spend time with friends made since their move to 2 High street. The inspector was able to see that service users are offered a wide choice of healthy and balanced meals Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 Service users choices are respected by the care practices within the home. The monitoring of health care needs are undertaken by competent staff. Recording of medication received and returned from the Pharmacists do not meet safe working practices. EVIDENCE: In observation of care practice within the home co-workers demonstrated that they are fully aware of how to maintain choice for service users with their personal care and that respect for others was a fundamental philosophy used to deliver the care. The files reviewed during the inspection confirmed that health care needs are fully met. There was evidence that families maintained a central role in specialist health care needs. Co-workers have undertaking specialist training on diabetic care and confirmed with the inspector that they have a full understanding of the monitoring required and actions to take if required. It was noted that the service users medical conditional had become more stable since admission and the GP had written to commend the co-workers for their continued support. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 14 Medication was seen to be stored appropriately and administration records were maintained. However the recording of medication coming into the home and its disposal was found not to be in place. It was discussed and agreed with the house manager that the system would be implemented at the next medication delivery from the pharmacist. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 standard(s) These standards were not inspected on this occasion. EVIDENCE: Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 standard(s) 24, 25, 26, 28, and 30 The home provides a comfortable safe and clean environment that meets the needs of service users and is of a high standard.. EVIDENCE: The home is on two floors with the ground floor being spilt level providing a choice of communal space for service users and co-workers to use. The home is well maintained and been sensitively restored. The inspector noted that the home was clean, hygienic and free from offensive odours. Service users have individual bedrooms and the inspector was able to accompany two service users to see how they had been arranged to the service users preferences. Service users are supported to maintain their own rooms and actively take part in other household chores. Co-workers support service users to take an active role within the home and take on a shared responsibility with co-workers. The dining room presently doubles as an activity room where service users can undertake crafts. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 32, 33, 34, and 36 The homes recruitment, induction, supervision and team working policies and practices ensure that service users are protected and well supported. EVIDENCE: Co-workers are appointed through a variety of methods. Some are recruited within the UK and go through the homes recruitment process. Others are community service volunteers (CSV) from overseas and have a rigorous recruitment process within their own country by the international CSV organisation. An additional criminal records bureau check is undertaken when they take up their position with William Blake House. Co-workers spoken with confirmed that they had undertaken a CRB on arrival at the home and were supervised during their induction period. The manager who is based at another home in the area holds the co-workers records and these are available for inspection. Co-workers all complete an induction programme and mandatory training. In observation of care practices within the home it is evident that an effective and competent team supports service users. Co-workers spoken with were very knowledge about individuals they supported and were able to maximise service user abilities. It was noticeable that service user behaviours noted in pre Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 18 assessment documentation were being managed and minimised by the level of support available and effective strategies. Co-workers receive regular supervision with a contracted consultant. Issues raised are dealt with through discussion with the consultant and manager. The co-worker keeps a record of supervisions. All co-worker spoken with said they benefited from the level support and the independent role of the consultant. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 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 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) 39 The home is in the early stages of developing a quality assurance system and was not able to fully meet the required standard. EVIDENCE: The inspector discussed with the Registered Manager and House Manager the development of a quality assurance system. Presently there is no developed system to record service users, their families, co-workers and professional views about the quality of the service provided. The responsible individual undertakes monthly monitoring reports required by the Care Home Regulations. These reports could form part of an annual quality assurance report along with other measures. Blakesely House C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 20 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 3 3 3 3 3 Standard No 22 23 ENVIRONMENT Score x x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 x 3 x 3 Standard No 11 12 13 14 15 16 17 3 3 4 3 3 3 3 Standard No 31 32 33 34 35 36 Score x 3 3 3 x 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Blakesely House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score x x 2 x x x x C51 C08 S62174 Blakesley House V230970 210605 stage 4.doc Version 1.30 Page 21 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 20 Regulation Requirement Implement a record s to show medication coming into the home and any that is returned to the pharmacist. Timescale for action 31.8.2005 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 39 Good Practice Recommendations It was agreed that the Registered Manager and House manager would develop an effective quality assurance system to demonstrate how views about the service are sort and actions taken. 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