Inspection on 08/05/06 for Bourne House

This inspection was carried out on 8th May 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Bourne House 22/05/07

Bourne House 30/01/06

Bourne House 14/09/05

Bourne House 04/01/05

Bourne House 13/07/04

Bourne House 16/03/04

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Bourne House 119 Mersea Road Colchester Essex CO2 7RL Lead Inspector Ray Burwood Key Inspection 8th May 2006 09:30 Bourne House DS0000031952.V293901.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 Bourne House DS0000031952.V293901.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. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Bourne House Address 119 Mersea Road Colchester Essex CO2 7RL 01206 577678 01206 578581 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) The Essex Autistic Society Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th January 2006 Brief Description of the Service: “Bourne House” is a family sized home and was opened in September 2002 by the Essex Autistic Society. The house provides accommodation and care for up to four adults with autism. The house is well decorated and furnished. There is a garden to the side of the house providing some privacy for service users. The service has good links with educational establishments and leisure services in Colchester, to the benefit of service users. The house is within walking distance of Colchester’s main shopping area. Small shops and health services are very close to the house. The range of monthly fees supplied to the Commission for Social Care Inspection (CSCI) on the 15th May 2006 and charged by the Society is currently between £1,056:19 and £1,081:54. There are additional charges for activities during the evenings and weekends. Individual service users meet all personal clothing, and items such as magazines and haircuts. Individual service users contribute £10:00 weekly towards transport costs in the evenings and weekends. Holidays – staffed accordingly with appropriate ratios. Staffing costs, transport and food between 9.00am and 5.00pm are met by the Society. Information about the service, including inspection reports, are made available to prospective service users through a pack containing information about all of the services provided by the Society, the Statement of Purpose, a current Newsletter, and literature regarding the Societies Jigsaw Study Centre. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced site visit was undertaken on the 8th May 2006 with the assistance of the Acting Manager, service users and staff. The site visit was carried out between the hours of 11.00am and 4.00pm. A tour of the premises, examination of service users’ and staff files was undertaken as part of the site visit. Also, a range of information from the preprepared inspection record contributed to the overall report. A total of 24 standards were inspected with nineteen being met. Discussions with service users’ was difficult due to their lack of verbal communication skills, but observations were carried out during the site visit of service users which included household routines and activities. However, one service user was able to describe partially his daily routine as enjoyable and he liked living in the home. Since the home’s last inspection, the Acting Manager had applied to the Commission for Social Care Inspection (CSCI) to become the Registered Manager of “Bourne House” and another small home close by. What the service does well: Since the Acting Manager has been in post, she has created a positive and homely atmosphere. Staff spoken with said they are supported by the manager and are able to approach her with any concerns or for advice. A dedicated, experienced and qualified team of staff supports service users. The service works well in ensuring that service users have a full and interesting daily routine and activities that include educational, social and leisure opportunities. Professionals within the Society, who provide a range of services at the Jigsaw Study Centre, support Service users. A Clinical Psychologist and an Assistant Clinical Psychologist also support the society. A programme of needs assessments is planned for some service users who have been accommodated by the Society for many years. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 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. Bourne House DS0000031952.V293901.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 Bourne House DS0000031952.V293901.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): 2. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home has appropriate admission arrangements that clearly link service users’ needs and wishes, to the services provided. EVIDENCE: Because of the length of time the current group of service users have been together at the home, original needs assessment documentation have been archived. The Society has commenced a programme of re-assessing all of the current service users in all of its homes who have been accommodated for many years, and whose needs and aspirations may have changed within that period. The assessment of individuals is extended to cover all aspects of their needs, and involves consultation with families, friends, agencies, and professionals involved in the lives of prospective service users. Documentation for assessing prospective service users are kept in the home with guidance contained in the Societies information manuals. Bourne House DS0000031952.V293901.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 and 9 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ care plans are comprehensively detailed, ensuring that their needs and wishes are met. Support is in place through formal advocacy arrangements, to enable service users to make decisions about their lives. EVIDENCE: Monthly visits to the home by the Director of Adult Services confirmed that service users records are up to date in relation to support plans, health action plans, and risk assessments. Service users plans inspected provided the evidence that service users are involved in the decision making process through review reports and meetings. Two service users are able to communicate verbally and made it known to the Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 10 inspector that they are able to contribute to the running of the home, albeit in limited ways. Service users who cannot communicate verbally do so through pictures, drawings and Makaton to enable them to be part of the decision making process in the home. One service user had devised her own communication system that involved drawings. Discussions with the Acting Manager and information contained in care plans indicated that some service users have formal advocates. One service user was making plans with his key-worker to visit his advocate in Kent. His advocate would also visit him at the home for meetings and reviews. None of the service users living in the home are able to manage their financial affairs. Records of service users’ finances were in line with the Societies policies and procedures, with expenditure and receipts submitted to Head Office for approval and clearance. Bourne House DS0000031952.V293901.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): 12,13,15,16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Links with the community are good, support and enrich service users’ social and educational opportunities. Dietary needs of service users are well catered for with a balanced and varied selection of food available that meets their tastes and choices. EVIDENCE: Individual service users timetables were made available by the Acting Manager, which reflected a full programme of events for the week. On the day of the site visit the programme of activities confirmed the movements of service users and staff supporting them. Care plans sampled during the site visit contained evidence of activity planning and recording. This evidence included the likes and dislikes of service users. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 12 Three of the service users living in the home attend the local educational college and the Essex Autistic Societies Jigsaw Study Centre where they participate in the following classes: • • • Music. Computing. Creativity Workshop One service user, who does not access the local education college, attends the Essex Autistic Societies Jigsaw Study Centre, social activities in the community, and is supported part of the week on a 1:1 basis. Overall, service users access a wide range of educational, social and leisure pursuits. Family contact is maintained through visits from family members and relatives to the home. One service user spends the weekends with his family. Contact for other service users is maintained through telephone calls, e-mails, and correspondence. The home had an open door policy on visitors with service users having the option of receiving visitors in their own room or in the home’s lounge area. The Acting Manager was aware of the need to promote house rules and daily routines that recognise service users disabilities, ensuring that any changes are agreed with service users. Service users were observed to be involved in housekeeping duties and had access and freedom of movement in the home. Service users had keys to their bedrooms. The home operates a four weekly rotational menu that was seen to be varied and included alternatives. The main meal of the day was taken at night and flexible to meet service users needs associated with evening activities. The home had a rota system for one service user to assist with the preparation and cooking of food. Bourne House DS0000031952.V293901.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 and 20. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The healthcare needs of service users are well met with evidence of good multi disciplinary working taking place. EVIDENCE: During the site visit staff were observed to provide support to service users that was dignified, and promoted their independence within a risk management framework. Staff spoken with explained that none of the current service user group required any technical aids or were receiving any specialist support. The Acting manager explained that she had had an initial meeting with the Societies Clinical Psychologist regarding the re-assessment of service users’ needs. One service user had recently had a medication review that was documented on his Care Plan. From evidence contained on the Care Plans examined, all service users are registered with a General Practitioner and healthcare professionals. Records are comprehensively detailed and adequately maintained. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 14 None of the current service user group is able to manage their own medication. The Acting Manager confirmed that there has been no change to the home’s medication policy and procedures since the last inspection visit. Bourne House DS0000031952.V293901.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 and 23. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff had a good understanding and knowledge of Adult Protection issues that protects service users from abuse. EVIDENCE: Key standard 22 was met in full at the last inspection. There have been no complaints received by the home or the Commission for Social Care Inspection (CSCI) since the home’s last inspection. The home’s Adult Protection and Whistle Blowing policies were clearly and comprehensively detailed. Staff spoken with confirmed that they had received appropriate training in recognising and responding to abuse situations. Bourne House DS0000031952.V293901.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 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. Service users live in a homely, comfortable and safe environment, however, some improvements would increase the benefits available to them. EVIDENCE: On the day of the site visit the home was seen to be fit for its stated purpose, being safe and accessible. There had been no major changes to the premises since the previous inspection. Service users’ bedrooms were decorated and furnished to a good standard with service users’ personal items evident. The Acting Manager agreed that some redecoration was required to improve the overall appearance of the home and the garden would benefit from a makeover. The laundry room that is situated outside the main building is suitable but not ideal in terms of all year access. Space could be made available in the kitchen for a washing machine with a little planning around existing facilities. Bourne House DS0000031952.V293901.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): 32,33,34, 35 and 36. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service user’s benefit from a well qualified, competent, and supervised staff team, however, staffing levels could place risks to service users and staff. The home operates a robust recruitment process that helps to protect residents living in the home from abuse. EVIDENCE: The home currently has four members of staff who are qualified to National Vocational qualification (NVQ) Level 2 or above. Two members of staff are currently working towards the Learning Disability Award Framework (LDAF) Positive Communication (Foundation) qualification. All staff have undertaken their First Aid and Protection of Vulnerable Adults training. Food Hygiene training is currently being undertaken by all staff at different stages. Training needs of staff continue to be identified through supervision sessions and the Societies induction programme, from which a personal development plan is initiated. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 18 The Acting Manager pointed out that staffing levels had been reviewed following the home’s last inspection where one member of staff was on duty in the morning, and one member of staff on duty in the afternoon, (Monday to Friday). One member of staff on each shift covers the weekends, where staffing levels are adequate to meet the basic needs of service users. Staffing levels have been increased during the week to provide additional cover throughout the day. Two staff files were sampled and inspected in respect of the home’s recruitment process. All files contained the documentation required under Regulations, however, not all files had a photograph attached. The Acting Manager said that she would ensure that photographs are placed on all files. Staff supervision is now taking place on a regular basis with Senior Support Workers taking on more responsibilities. The Acting Manager was advised to ensure that those undertaking the supervision of staff complete supervision skills’ training. Bourne House DS0000031952.V293901.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): 37,39 and 42. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The Acting Manager is well supported by the senior staff in providing clear leadership throughout the home ensuring the health and safety of service users, staff, and visitors to the home. EVIDENCE: The Acting Manager of the home, who has applied to the Commission for Social Care Inspection to become the Registered Manager of Bourne House and another small home close by, has many years experience of working with people with autism. Her experience includes a care background and more recently as a manager for the Essex Autistic Society. Discussions with staff during the site visit about the management and changes to the service were positive, with staff feeling very supported. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 20 Management training has been highlighted for the Acting Manager to commence as soon as a provider becomes available, possibly later in 2006. The homes quality assurance report is contained in the organisations Quality Assurance Audit and Report undertaken by “Autism Accreditation” on behalf of the Essex Autistic Society. Although grouped with other homes, the report is specific to Bourne House. Further development in the Quality Assurance system is outlined in the homes recent Action Plan, and includes confidential questionnaires to parents, and meetings with parents and advocates. Quality assurance survey forms are in place in Widget format for all service users to complete Surveys and questionnaires to other interested parties and stakeholders are sent out from Central Administration with the results contained in the above report. The Acting Manager was advised to look at carrying out surveys amongst other professionals and stakeholders who support the home, and who may not be known to Central Administration personnel. Maintenance and associated records/checks evidenced through the site visit and pre-inspection questionnaire. There were no concerns or health and safety issues presenting in the period between the last inspection and the site visit. Monthly visits to the home undertaken by Adult Services personnel, confirmed that there were no current health and safety concerns. Bourne House DS0000031952.V293901.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 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 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 2 34 2 35 3 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X 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 2 X 3 X X 3 X Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 22 Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 23 YES 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 YA33 Regulation 18(a) Requirement The registered person must review the staffing levels / arrangements at the home, particularly at weekends, to ensure that service users and staff are not at undue risk. The registered person must ensure that staff carry out supervision duties have received the appropriate training. The registered person must ensure that the manager of the home has the appropriate qualifications to manage the home or has commenced the training within the timescale for action. Timescale for action 31/07/06 2 YA36 19(5)(b) 31/07/06 3 YA37 9 (2)(b) 30/09/06 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 YA34 Good Practice Recommendations The registered person should ensure that staff files contain DS0000031952.V293901.R01.S.doc Version 5.1 Page 24 Bourne House 2 YA24 up to date photographs of staff. The registered person should include in the home’s budget, provision for premises upgrades internally and externally. Bourne House DS0000031952.V293901.R01.S.doc Version 5.1 Page 25 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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. 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