CARE HOME ADULTS 18-65
Chase House 95 Chase Road Brownhills Walsall West Midlands WS8 6JE Lead Inspector
Maggie Bennett Unannounced Inspection 1st March 2006 03:30 Chase House DS0000020846.V284762.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 Chase House DS0000020846.V284762.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. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Chase House Address 95 Chase Road Brownhills Walsall West Midlands WS8 6JE 01543 252063 01543 300399 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 Angela Lane Mr Peter David French Mr Danny Page Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st September 2005 Brief Description of the Service: Chase House provides care for four people with autism. The home is designed to meet the continued education needs of service users through their development into adulthood. Chase House offers structured activities and full use is made of community based provision. The property itself is set back from the main road on the outskirts of Brownhills. All bedrooms are single, each service user having been involved in choosing the décor and furniture. The garden is small, with a patio and lawned area. There is a drive to the front of the property with very limited parking. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on a weekday between 3.30 p.m. and 6.00 p.m. Key standards either not met or not assessed during the last visit were inspected on this occasion. During the course of the day all the service users were seen and discussion took place with two members of staff and the registered manager of the home. The care plans of the service users were seen and the staff records of two newly appointed staff were inspected. A tour took place of some areas of the building. It was found that 3 of the 4 statutory requirements made at the last inspection had been met. 3 further statutory requirements were made on this occasion. There have been no new service users admitted since the last inspection. There have been some staff changes. What the service does well: What has improved since the last inspection?
All senior staff have recently taken part in training in physical restraint. The home now have a clear system in place should service users wish to purchase items of furniture above and beyond that provided by the home. Because service users have difficulties with communication their representatives or advocates have been requested to sign their agreement if additional items are purchased. Any such purchases are also to be discussed at Review Meetings. A number of new staff have been appointed since the last inspection and there was evidence on this occasion that no new staff commence work until satisfactory checks have been made. Care plans are now being regularly reviewed and updated where necessary. It was clear from the staff files seen that no new staff commence until the home have received satisfactory recruitment checks. Advice has been sought from the Fire Officer regarding an emergency exit from the garden and this has now been provided. There are plans for continued redecoration and refurbishment in the coming months.
Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 6 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. Chase House DS0000020846.V284762.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 Chase House DS0000020846.V284762.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): None. It was found at the last inspection that there are sound assessment procedures in place at Chase House, which ensure that service users’ needs are met. The specialist needs of individual service users are met, with relevant training and professional advice being obtained. EVIDENCE: Standard 2 was met at the last inspection and Standard 3 was exceeded. Chase House DS0000020846.V284762.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): None. It was found at the last inspection that the home had clear care planning systems in place to ensure that service users’ needs are met and goals pursued. Service users are assisted to make decisions about their lives. Systems are in place to minimise risk to individuals, whilst supporting them to be as independent as possible. EVIDENCE: Standards 6, 7 and 9 were all met at the last inspection. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 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): 13, 15 and 16. Service users are very much part of the community and take part in a number of activities locally. Family links are maintained and encouraged and service users benefit from this continued contact. Service users’ rights to independence are respected as far as possible and they are encouraged to take part in the daily routines of the home. EVIDENCE: Standard 12 was exceeded at the last inspection and Standard 17 was met. Service users take part in a number of leisure activities within their local community. This includes the local Pub., shopping in the High Street at Brownhills, and horse riding. Chase House has its own “people carrier” and this is used for trips further afield. Service users are also accompanied on public transport for visits to local places of interest. In addition they regularly visit the Company’s Day Centre in Brownhills. All the service users are on the electoral register, although none are politically active at present. All staff time with service users outside of the home is recognised as part of their duties. The home does try to reflect the racial and cultural diversity of its service users and there are African Caribbean carers among the staff group.
Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 11 Family links are maintained and service users are assisted to keep in touch in a variety of ways. The majority of service users see their relatives on a regular basis. Service users are assisted to send letters home each week and the letters include photographs. There is the opportunity to make new friends at the various clubs visited. The home have clear policies and procedures, should service users wish to develop intimate personal relationships. It was observed during the inspection that staff only enter service users rooms after knocking on the door. It is planned that all individual rooms will be lockable and service users offered a key. Any mail to a service user is opened with them. It was observed during the visit that staff and service users interact as a group and staff do not talk exclusively amongst themselves. This includes mealtimes, with staff taking their meals with the service users. Service users have unrestricted access to all parts of the home, within the context of a risk assessment. There are no strict rotas for housekeeping tasks at the home, but service users are encouraged to assist with some tasks. During the inspection a service user was assisting in the kitchen with the preparation of the evening meal. There are clear policies with regard to smoking, alcohol and drugs. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 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): None. It was found at the last inspection that personal support to service users is given in private. Healthcare needs were found to be clearly documented and specialist advice obtained to ensure that these needs are met. Medication procedures were found to be clear and to protect service users. EVIDENCE: Standards 18, 19 and 20 were met at the last inspection. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 13 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): 23 and 22 There is a complaints procedure in place and staff at the home use a variety of methods of communicating this to the service users. EVIDENCE: The home have a Complaints Procedure in place and this is available in an accessible format. None of the present service users have speech, but it was observed during the inspection that staff use a number of different ways of communicating with the service users. There are various symbols and pictures around the home indicating how complaints can be made. The current procedure has the wrong address of the local office of the Commission and this must be changed. The home have not received a complaint for the past 2 years. Standard 23 was mostly met at the annual inspection. A statutory requirement was, however, made with regard to the home’s responsibility for the purchasing of furniture for individual bedrooms. This is currently being dealt with and letters have been sent to service users’ representatives. The situation should be resolved by 30th April 2006. All senior staff took part in training in Physical Restraint in February 2005. The Registered Manager is to attend a 10 day accredited course on Physical Restraint and will cascade this training to other staff. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 14 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): 26 Chase House is homely, warm and comfortable and provides a safe environment for the service users. Improvements to the décor are ongoing and service users are involved in personalising their rooms. EVIDENCE: Standards 24 and 30 were met at the annual inspection. The Registered Person has taken advice from the Fire Officer and a suitable gate has been fitted to the rear garden to provide a safe exit. There are plans to provide new carpets to two bedrooms, hallways and the first floor bathroom. This work will be done during the service users’ summer holiday. It is recommended that a key in a breakable box be provided by the back door near to the ground floor toilet, so that the door can be opened quickly in the event of an emergency. Standard 26 was mostly met at the last visit. Service users have not yet, however, been provided with suitable locks for their bedrooms. It is understood that this is currently “on hold” as the bedroom doors may have to be changed to meet the recommendations of the Fire Officer. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 15 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): 34 Recruitment procedures are generally good and had improved since the last inspection. Risk assessments must, however, always be carried out on staff employed on the basis of a POVA First check in order to protect the service users. EVIDENCE: Standards 31, 33, 35 and 36 were met at the last inspection. Since the last visit, there has been some staff turnover and a number of new staff have been appointed. The files of two newly appointed staff were seen at the inspection. In both cases there was a completed application form and two written references on file. One of the application forms did not, however, contain a full employment history. Where there are gaps, these must always be explored with the applicant and reasons for the gaps recorded. The files contained the majority of the required documentation. Although satisfactory POVA First clearance had been received, there were no risk assessments in place for these two members of staff. The Registered Manager undertook to ensure that these were faxed to the Commission the following day. Both new members of staff had received statements of their terms and conditions and both were subject to a 3-month probationary period. There are no volunteers employed at the home. The new members of staff were spoken to during the inspection and both were very much enjoying working at the home. They felt that the service users received excellent standards of care. The staff had received induction training when they commenced at the home and a number
Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 16 of relevant training courses were booked for them for the future. Both staff confirmed that until their satisfactory Criminal Records Bureau checks had been received, they always worked under supervision and were not administering medication. There are no volunteers employed at the home. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 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 and 39. Chase House is well managed and administered and there are clear development plans in place. EVIDENCE: The registered manager is well qualified and experienced. He has achieved the Registered Managers’ Award and NVQ4. The manager has a clear job description, which covers all those areas listed in Standard 37.3. The manager has undertaken a number of relevant training courses, including infection control, safe handling of medicines, fire safety, first aid, health and safety and Spirituality. He is an NVQ Assessor and Basic Skills Counsellor. He is about to undertake a 10 day accredited training course on physical restraint. Chase House uses a number of methods to obtain the views of its service users and other interested parties, including parents, social workers and NVQ Assessors. A “Stakeholder Survey” is carried out on a regular basis and this is shortly to be extended to seek the views of G.P.s, nurses and the home’s staff. The views received are published in the Service Users’ Guide. A copy of this document is to be sent to the Commission in future. The home also carries out
Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 18 an annual audit. Service users’ views are sought with the support of their parents or advocates. The home is also planning to produce an Annual Development Plan. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 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 X 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 2 23 3 ENVIRONMENT Standard No Score 24 X 25 X 26 2 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 X 34 2 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score X X X X X LIFESTYLES Standard No Score 11 X 12 X 13 4 14 X 15 3 16 4 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X X x 3 X 3 X X X X Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 20 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 YA22 Regulation 22(7) Requirement Timescale for action 31/03/06 2 YA26 12(4)(a) 3 4 YA34 YA34 19 19 The Complaints Procedure must include the correct address of the local office of the Commission for Social Care Inspection. All service users must have a 30/04/06 key (or suitable locking device) to their bedroom, unless a risk assessment demonstrates otherwise. (Previous timescales of 31/05/05 and 31/12/05 not met). It is understood that this provision is “on hold” until further discussions have taken place with the Fire Officer. Any gaps in employment must 01/03/06 be explored with the applicant and recorded. Where staff are employed on the 02/03/06 basis of a POVA First check, a risk assessment must be in place. (Risk Assessments were received by the Commission on the day following the inspection). Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 21 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 YA24 Good Practice Recommendations It is recommended that a key in a breakable box be provided by the back door near to the ground floor toilet, so that the door can be opened quickly in the event of an emergency. Chase House DS0000020846.V284762.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection Halesowen Record Management Unit Mucklow Office Park, West Point, Ground Floor Mucklow Hill Halesowen West Midlands B62 8DA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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