Inspection on 07/06/06 for Butterfly`s

This inspection was carried out on 7th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

Other inspections for this house

Butterfly`s 26/06/07

Butterfly`s 24/01/06

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Butterfly`s 1 Bromley Road Colchester Essex CO4 3JE Lead Inspector Neal Wolton-Harragan Unannounced Inspection 7th June 2006 10:00 Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Butterfly`s Address 1 Bromley Road Colchester Essex CO4 3JE 01206 322719 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) Mrs Julie Elizabeth Webster Mr Manus Webster Mrs Caroline Joseph Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 6 persons) Mr Manus Webster will not take part in running, or have any other operational interest in the business of providing residential care within the care home 24th January 2006 Date of last inspection Brief Description of the Service: Butterfly’s is a small home, registered to meet the needs of up to 6 younger adults with learning disabilities. Situated on the outskirts of Colchester, the bungalow has been extended and remodelled to offer six single en-suite bedrooms as well as sufficient communal space. The home is on principal public transport routes for easy access to central Colchester and is within walking distance of local shops. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced key inspection at Butterfly’s, the first inspection at the home for the 2006/07 inspection year. Mrs Caroline Joseph, the Registered Manager, was at the home from 10:45 and contributed fully to the inspection process. Prior to Mrs Joseph’s arrival, the shift was being led by a senior carer who was able to provide the Inspector with the information needed. This inspection consisted of a tour of Butterfly’s and discussions with 2 carers and 3 service users, as well as the examination of records, policies and procedures. Staff and service users spoke well of the home and of its management, service users appeared at ease with the care staff and were happy to talk to the Inspector. Interactions between staff and service users observed during this inspection were positive. During this inspection, 32 of the 43 applicable standards were looked at; 31 were met and one was nearly met. All of the key standards were looked at. What the service does well: 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. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 6 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 Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 7 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, 4 & 5 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The individual aspirations and needs of prospective service users were assessed, those considering entering the home had the opportunity to visit and to test drive the service and each service user had an individual written contract with the home. EVIDENCE: Care records for three service users were examined and showed that a comprehensive needs assessment was conducted prior to service users entering the home, with input from the service user, care manager, relatives and other services (either residential or day care). These assessments formed the basis of the service users’ initial care plans and contributed to the on-going process of assessment within the home. Service user records also contained care package summaries and contracts of residence. Discussions with care staff and the Manager, as well as the examination of service user records, gave evidence that prospective service users were given the opportunity to visit the home before they made the decision to stay and were able to have a phased introduction to Butterfly’s. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 8 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. This judgement has been made using available evidence, including a visit to this service. Service users knew their assessed and changing needs, and personal goals were reflected in their individual plan. Service users make decisions about their lives, are consulted on, and participate in, all aspects of life in the home and are supported to take risks as part of an independent lifestyle. EVIDENCE: Service user plans examined as part of this inspection showed that individuals had contributed to their construction. Service user records gave details of the individuals contribution to the decision-making process and involvement in the review process. Conversations with people living at the home showed that service users knew how their contributions to the review process were reflected in their plans of care. The care plans reflected the individuality of the service users and the uniqueness of each person’s needs. Conversations with carers showed that there was an understanding of the issues within the individual plans of care and that these were followed and entries in daily records gave evidence to support this. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 9 The service user records examined showed that comprehensive risk assessments had been undertaken and that these were regularly reviewed. Conversations with service users and staff indicated that people living at the home were consulted regarding activities and the day-to-day running of Butterfly’s, both individually and through service user meetings, and were able to participate in all aspects of life at the home. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 10 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, 14, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users had opportunities for personal development and were able to take part in age, peer and culturally appropriate activities. Service users were part of the local community, engaged in appropriate leisure activities and had appropriate personal, family and sexual relationships. Service users’ rights were respected and responsibilities recognised in their daily lives. A healthy diet was offered to service users. EVIDENCE: Service user records sampled showed that each person living at Butterfly’s had a detailed weekly programme of activities both inside and outside of the home. These activities included work, education and leisure type activities. Service users spoken with on the day of inspection stated that they used community facilities as part of their daily lives and enjoyed the activities on offer. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 11 Discussion with service users and staff, as well as the examination of records, showed that service users’ rights were respected and appropriate personal relationships supported. Visitors were welcome at the home at any time and service users were able to receive gusts in private if they wished. Records and discussions with the Manager provided evidence of those living at Butterfly’s receiving a healthy diet. Menus were developed through discussions with service users and service users were encouraged to take part in meal preparation. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 12 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 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users received personal support in the way they preferred and required and physical and emotional health needs were met. No service users retained their own medications at the time of this inspection. EVIDENCE: Service users spoken with were happy with the way they were supported and this was reflected within the care plans examined. Care plans identified individual needs as well as the service users’ preferences for how these needs could be met. Care plans were well detailed; regularly monitored and formal reviews were held at six-month intervals. There was an ongoing process of assessment, to take account of the changing needs of individuals, and the services of healthcare professionals - such as community nurses, speech and language therapists or psychologists - were accessed as necessary. No service users retained their own medications at this inspection; all medications (with the exception of insulin) were kept within a locked cabinet in the home’s office. Only three of the six service users were prescribed regular medications and two of these were effectively self-administering with support Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 13 from the care staff. All medication records examined were appropriately maintained and the home’s medication policies and procedures provided protection to the service users. Medication practices observed showed that care staff adhered to the policies and procedures. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 14 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 good. This judgement has been made using available evidence, including a visit to this service. Arrangements were in place to help protect service users from abuse, neglect and self-harm and their views were listened to and acted upon. EVIDENCE: The home had a robust complaints procedure and this was also presented in a manner that was easy for service users to understand. The adult protection policies and procedures were adequate to protect service users from abuse and, where service users presented with behaviours likely to cause self-harm, these behaviours were identified within their care plans and management strategies devised. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 15 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, 28 & 30 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users lived in a homely, comfortable and safe environment and had bedrooms that suited their needs and lifestyles, as well as promoting independence. Service users toilets and bathrooms provided sufficient privacy and met individual needs. Shared spaces complemented and supplemented service users individual rooms. The home was clean and hygienic. EVIDENCE: An environmental tour of the home gave evidence that service users lived in a homely, comfortable and safe environment and that individual bedrooms suited service users’ needs and lifestyles and promoted independence. All rooms had en-suite toilet facilities. There were sufficient shared spaces throughout the home, and within its grounds, to complement and supplement service users’ individual rooms. The Manager also advised that there was an intention to remodel the lounge and dining rooms to provide additional space for the service users. All areas of the home were clean and hygienic. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 16 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 Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Staff were appropriately trained to meet the individual and joint needs of service users and competent and qualified staff supported service users. Service users were protected by the homes recruitment policies and practices. EVIDENCE: Examination of staff records, as well as discussions with the Registered Manager and staff, gave evidence that care staff were qualified and competent. Staff were employed in sufficient numbers to meet the needs of the service users, creating an effective staff team. Staff spoken with on the day of inspection stated that training was regularly made available and the home’s Manager fully supported staff in meeting their training needs. Two carers had completed NVQ programmes and another two were hoping to commence similar programmes in the near future. Staff were observed as caring and professional and interactions between carers and those living at Butterfly’s were positive and encouraged independence for the service user. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 17 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, 41 & 42. Quality in this outcome area is adequate. This judgement has been made using available evidence, including a visit to this service. The home was well run, with a positive ethos. The leadership and management approach of the home was good and a quality assurance process had been commenced. The home promoted and protected the health, safety and welfare of service users, staff and visitors. Service users’ rights and best interests were largely protected by the home’s record keeping policies and procedures. EVIDENCE: Service users and staff spoken with on the day of inspection were positive about the management style adopted in the home and staff felt able to raise concerns with, or make requests to, the Manager. Mrs Joseph, the Registered Manager, showed a good understanding of management issues and was close to completing the NVQ level 4 in Management and Care. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 18 The home had regular service user meetings and a formal quality assurance process had been commenced. Records were largely Records examined showed that the health, safety and welfare of service users, staff and visitors was protected and promoted. While the home’s record keeping policies and procedures largely protected the rights and best interests of those living at Butterfly’s, two of the three service user records examined did not contain photographs. This was discussed with the Manager who agreed to ensure that this was addressed. Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 19 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 3 5 3 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 3 27 X 28 3 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 3 3 X 2 3 X Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 20 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. 1. Standard YA41 Regulation 17(1)(a), Schedule 3 Timescale for action The registered person must 01/08/06 ensure that all records required in respect of service users are adequately maintained. Requirement RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 21 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. Extracts may not be used or reproduced without the express permission of CSCI Butterfly`s DS0000064355.V299037.R01.S.doc Version 5.2 Page 22 - 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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