Inspection on 13/06/07 for Byron Court

This inspection was carried out on 13th June 2007.

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 found no outstanding requirements from the previous inspection report, but made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Byron Court 24/06/08

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 Byron Court 55 Chaucer Road Bedford MK40 2AL Lead Inspector Shirley Christopher Unannounced Inspection 13th June 2007 10:20 Byron Court DS0000068342.V338298.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 Byron Court DS0000068342.V338298.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. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Byron Court Address 55 Chaucer Road Bedford MK40 2AL 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) 01707 652053 www.caretech-uk.com Caretech Community Service Limited Mrs Jane Elizabeth Snow Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: N/a Date of last inspection New service Brief Description of the Service: Byron Court is owned and managed by Caretech Community Care Service Ltd. They are a large service provider and are already operating care homes in other regions. Byron Court is a new service, which was registered late last year. The service provides accommodation for up to six residents with a primary diagnosis of learning disability, but they have recently applied for a variation to their main category of registration, which will be dealt with by the Registration Team. The property is situated close to the town of Bedford, with easy access to all major routes and close proximity to Luton and Milton Keynes. The fees for the service are from £1,600 per week for a room to £2,625 a week for a flat. Additional charges are made for transport costs. This is offset from the resident’s mobility allowance. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was carried out on 13 June by two inspectors. On the day there were two residents at the home, both were spoken to briefly and the interaction between staff and residents was observed. There was an acting manager in post, who is not yet registered with the CSCI. The registered manager is still in post and providing support to the new manager. The new manager had only been in post for a week at the time of inspection and was in the process of familiarising herself with the service, staff and residents. She was able to produce the records requested. The inspectors case-tracked one resident’s records and looked at staff records, observations were undertaken and three staff spoken to at length. What the service does well: What has improved since the last inspection? What they could do better: There are a total of 4 requirements and 3 recommendations arising from this report, which need addressing. An immediate requirement was left following the inspection with regards to the unsafe administration of medication. The home must ensure that staff members are clear about how to manage behaviour problems and have clear intervention strategies in place, which are carefully recorded. The administration of medication for behavioural reasons must be supported by a clear protocol. The home has good records, but some of these records had not taken into account the changes in residents’ circumstances and behaviour. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 6 The level and variety of social and recreational activities must be improved to maintain an adequate level of stimulation for the development and welfare of residents. Maintenance and repairs identified under standard 24 must be addressed. A profile of each resident that provides essential information in an easy format should be introduced; this would assist relief staff to better meet the needs of residents. A pictorial complaints procedure should be produced and a copy made available to each service user. 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. The summary of this inspection report can be made available in other formats on request. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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 Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2 and 4 Quality in this outcome area is good. The staff team including the manager understand the need to support the service user and their family to make an informed decision regarding the suitability of the home This judgement has been made using available evidence including a visit to this service. EVIDENCE: A service user’s guide is available to residents, their representative and professionals. Full assessments are made of every prospective resident’s needs, abilities, personal preferences and aspirations prior to admission. Staff spoken with said that every opportunity would be given for the prospective resident, their relatives and significant others to visit the home and assess for themselves the services offered and the suitability of the home. A minimum ‘settling in’ trial period of residence would then be offered. This is followed by a placement review at the end of six weeks. Only then is the placement finalised. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome area is adequate. Care plans are available for each resident however they need to be more detailed and kept up to date to ensure their needs are fully met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The records of one resident were inspected. There was a person centred plan in place which included photographs and gave some background information about the person and included what help they needed, their likes and dislikes and most areas of daily living and preferred routines for this person. Some evidence was provided that their needs had been reviewed and the acting manager stated that they are reviewed at least six monthly. Some of the information on the care plan did not refer to changes in behaviour, which were significant. The acting manager stated it was difficult to engage the resident in purposeful activity but staff regularly interacted with them. This should be evidenced through daily notes. Other health issues, which would have an impact on behaviour, were not mentioned in the care plan. There was evidence that this person had an assessment from other external agencies almost a year Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 10 ago and the placing authority had not reviewed their needs since even though their needs had changed significantly. The acting manager stated that they had made regular contact with the care manager. There was some evidence of health care professionals involvement and in particular input from the psychologist, who was looking at’ behavioural issues.’ A treatment programme had been put in place, but records were not seen showing how the programme was being implemented although it was clear through discussion that staff were adhering to the programme. Clearer guidelines need to be in place with regards to the management of challenging behaviour and when particular interventions may be appropriate. The home does use relief staff and it may be useful to have a profile of each resident which gives essential information in an easy format, as the main files contain a lot of information and some of it is out of date and would not enable a new member of staff to meet the residents needs in the most appropriate way. A number of risk assessments were seen. A risk assessment had been updated following an incident, but information from the level 2 assessments had already highlighted these risks and they had not been addressed by the risk assessment. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14,15, 16 and 17 Quality in this outcome area is good. Residents are able to maintain contact with family and friends as they wish. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One resident was out at the time of inspection. Another resident had stopped attending the day service and an alternative place have been found and funding agreed as part of the overall care package. A third person was at home throughout the day, because of health issues, which were being closely monitored. Care plans provided details of the social and recreational activities identified for each individual. Staff members spoken with demonstrated a good understanding of residents’ interests taking into account any religious and cultural needs as well as individual preferences. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 12 Family contacts and other personal relationships are encouraged. Residents have a healthy and balanced diet. A weekly menu is available and staff said that the menu is discussed and changes made according to the residents wishes. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is adequate. Residents’ health care risk assessments must be person centred to ensure that identified risks can be addressed. Administering p.r.n medication, without appropriate protocols, is dangerous and does not adequately protect residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: One resident’s file was inspected and showed that the home monitor resident’s health and does so in consultation with appropriate services. Evidence was provided of GP and psychology involvement. The chiropodist had seen the person regularly, but no evidence was seen of optical and dental treatment. Medication reviews had been undertaken. One person required regular monitoring of blood sugar, but would not consent to blood tests. This potentially puts the person at risk and should be documented and a plan of action put in place. The person had a health action plan on file. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 14 In another case, medication was being administered as and when necessary, (PRN.) No protocols were in place to inform staff when medication would be an appropriate course of action to follow, or if other interventions may be worthy of considerations. This is extremely dangerous and places the safety and welfare of residents at risks. An immediate requirement notice was served with regards to the unsafe administration of (PRN) medication. Other professionals, residents have access to include dentist, physiotherapist, occupational therapist, podiatrist, community nurses and other specialist professionals. Some of these professionals also contribute to resdients’ care plans and attend their reviews. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. Therhome has an a complaints proecdure in place so that residents can complain, howver this need to be developed in a more user frinedly forma so that it is more accessible to residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information regarding how to make a complaint is included in the service user’s guide and the home’s statement of purpose. Members of staff demonstrated a good understanding of the need to investigate and record all complaints. Information gathered suggests that staff routinely inform residents about the complaint procedures. Given the severe learning disabilities of the residents accommodated at the time of the visit, it was not appropriate to seek their views, in order to gain any accurate information regarding this subject. Given the level of the learning disabilities of residents, a pictorial complaints procedure should be available. A copy of the Bedfordshire Adult Protection policy and procedure was not available at the home. Staff members spoken to, confirmed that they have received training on Adult Protection; this subject is also covered in individual supervision and the induction programme for all new staff. There is also a three monthly questionnaire to complete. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. The home is well maintained and provides a comfortable environment for residents. This judgement has been made using available evidence including a visit to this service. EVIDENCE: All six bedrooms in the home are for single occupancy and include toilet/shower en-suite facilities. Each bedroom was well furnished and contained furnishings and fittings chosen by the occupants. Each room was reasonably decorated to suit the taste and preference of the occupant. There are two pleasant lounges, a dining room, a modest size kitchen and a well-equipped laundry facility. The bathroom and toilet provision is sufficient for the number of residents in the home. The bathroom is on the first floor so residents must be physically able to climb stairs to access it. It was pleasing to note that a sensory is being developed for residents. It was noted that the carpets in flat 1 and both offices are stained and would benefit from a replacement and that the first floor staff office and a resident bedroom (No 2) did not have a door lock. The home was very clean. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 and 36 Quality in this outcome area is good. Residents receive their care form trained staff, in suffiecnt numbers to meet their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The staff rota was seen and staff confirmed that there are enough staff on duty to meet the needs of the residents. Staff members have adequate experience and skills to enable them deliver a good service to the residents. Staff said that they felt well supported as there are shift handovers, regular team meetings and annual appraisals. The recruitment files for two members were seen and these were found to contain appropraite police checks and references. Information gathered indicates that the staff team benefit from a good level of training. All members have received their mandatory training. “Most impressed with the level of training” said one staff member. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 18 Information available indicates that staff members are being offered formal supervision within the stated frequency. All staff members interviewed expressed a good deal of satisfaction regarding the quality of supervision they received. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39, 41 and 42 Quality in this outcome area is good. The overall management of this home remains satisfactory. Records must be kept up to date for the protection of residents. In the main, Byron Court is a safe home for residents to live in – a view shared by staff members This judgement has been made using available evidence including a visit to this service. EVIDENCE: The Registered Manager was reported by staff to be approachable, helpful and constructive. She was due to take on a different job within the same organisation from 1 July 2007. A new manager has been in post for about a week and was being inducted at the time of the inspection visit. She has submitted an application to the CSCI to become the registered manager of the home. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 20 The relationship between the residnets and the staff was positive and interactions observed were conducive to good practice. The ethos and management approach of the home creates an open, positive and inclusive atmosphere, and staff spoken to felt well supported. There is a clear commitment to equal opportunities within the home. The home has a range of policies and procedural guidelines and staff members spoken to confirmed that they were familiar with these. Quality Assurance systems are in operation to ascertain the views and experience of service users, relatives and significant others. All statutory records required, were available and these were found to be satisfactory, except that some of these records had not been updated with respect to changes in residents’ circumstances – for example, changes in behaviour. Staff members receive ongoing training that ensures safe working practice. Cleaning materials were stored appropriately and fire equipment and the fire alarm system including smoke detectors and emergency lighting are serviced regularly. Fire drills and weekly tests of break-glass points are carried out as required. Hot water temperature is tested regularly and portable electrical appliances are checked, tagged and a record maintained. Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 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 3 2 3 3 x 4 3 5 N/A INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 2 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 x 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 2 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 2 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 1 x 3 x 3 x x 3 x Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 22 Are there any outstanding requirements from the last inspection? N/A as this is the first inspection of a new service 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 YA9 Regulation 13 (4) (b) Requirement The risk assessment must be person centred, in order to ensure that identified risks are addressed. Appropriate protocols must be available to staff when administering medication as and when required (PRN). (An immediate requirement notice was served). Maintenance and repairs identified under standard 24 must be addressed. Records must be kept up to date for the protection of residents. Timescale for action 15/08/07 2 YA20 13 (2) 13/06/07 3 4 YA24 13 (4) (a) 17 31/07/07 15/08/07 YA41 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 YA9 Good Practice Recommendations Clearer guidelines should be in place with respect to the DS0000068342.V338298.R01.S.doc Version 5.2 Page 23 Byron Court 2 YA6 management of challenging behaviour and when particular interventions may be used. A profile of each resident that provides essential information in an easy format should be introduced; this would assist relief staff to better meet the needs of residents. A pictorial complaints procedure should be produced and a copy made available to each resident. 3 YA22 Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Bedfordshire & Luton Area Office Clifton House 4a Goldington Road Bedford MK40 3NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Byron Court DS0000068342.V338298.R01.S.doc Version 5.2 Page 25 - 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. 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