CARE HOME ADULTS 18-65
Christchurch Court 2 Christchurch Road Abington Northampton Northants NN1 5LL Lead Inspector
Ms Sarah Jenkins Unannounced Inspection 21st November 2005 08:50 Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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 Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Christchurch Court Address 2 Christchurch Road Abington Northampton Northants NN1 5LL 01604 639838 01604 631895 enquiries@christchurchcourt.co.uk 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) Marigold Contracts Limited Mrs Miranda Newman Care Home 23 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (23) of places Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. No person falling within the category MD, excluding learning disability or dementia can be admitted where there are 23 persons of category MD already in the home. The age range of Service Users is between 19 - 65 years The overall numbers may include one exisiting named service user who is over the age of 65 and who also has a Physical Disability. All service users admitted to the home will have an aquired brain injury. The total number of services users accommodated at any one time must not exceed 23. 2. 3. 4. 5. Date of last inspection Brief Description of the Service: Christchurch Court is a care home providing personal care and accommodation for 23 service users with Mental Disorder with all service users having an acquired brain injury. The age range of service users is 19 to 65 years with an additional condition that the home may continue to provide care for one existing named service user over the age of 65 years. The Home is owned by Marigold Contracts Ltd. and the Manager is Mrs. M. Newman.The Home is located in a suburb of Northampton, close to a local shopping centre and nearby park. The Home is easily accessible by Public Transport.The premises consist of a two-storey building offering all single room accommodation. 11 of the bedrooms have en-suite facilities. There are two lounge areas, a dining room and a conservatory. The Home does not have a lift. There is a courtyard garden area. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements and the minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting 2 service users and tracking the care they receive through meeting with the service users, a review of their records, discussions with the care staff and observation of care practices. The Inspector visited during the morning to observe practices by staff and to meet with service users. Service users have acquired brain injuries and thereby communication for some is difficult. Establishing Service Users choices and informed decisions is dependant to some extent upon the consistency of staff, service users relationships with staff, and the quality of communication. Feedback obtained from Service Users in this report was in part through observations of their relationships with staff, and also through interpretations of their general levels of happiness with their routines. The Inspector spent just under an hour in preparation for the inspection and over two hours at the home. There was no self-assessment questionnaire from the home available for this inspection or any feedback comment cards. What the service does well:
The staff at Christchurch Court are properly focussed on the individual needs of the Service Users, and enable them to develop fulfilling lifestyles and routines that incorporate all their rights as individual members of the community. The staff team is committed to providing a professional service and staff feel well supported by the management team and the larger organization. Staff met at the time of the inspection demonstrated warm and caring attitudes, and the delivery of care in a quietly calm and effective manner. Service Users are being properly involved in information about the phased building development work and although there is inevitably some disruption to them in a development of this kind, they reported to the inspector that they were being considered and included in decisions, and that additional outings had been organized to minimize the impact of the disruption. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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 Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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 This area was not reviewed at this inspection EVIDENCE: Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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 Service Users know that their changing needs are reflected in their care plans and are responded to by staff. EVIDENCE: Service Users discussed their care needs and care plans with the inspector and showed complete confidence in the staff in assisting them to work towards their goals. Care plans were clear, well presented, and regularly updated and reviewed. There were recent review reports that were informed and relevant, on the two Service Users records reviewed by the Inspector. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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): 11,13 Service Users are enabled to lead normal and fulfilling lifestyles within the confines of their disabilities. EVIDENCE: Service Users expressed satisfaction with the opportunities they have for personal development, both in their skills and interests. There was lively discussion, that demonstrated their enthusiasm and motivation, when Service Users told the inspector about their lifestyles. It was evident that Service Users “looked out” for one another and included less able residents in their discussions and lifestyles. Service Users explained to the Inspector how they were able to communicate with others who did not have verbal communication. Staff explained to the inspector how this ethos was developed and expected among Service Users as a part of the culture of the home. Service Users are generally enabled to access all community services unless they are physically unable to do so. It was evident that Service Users are able to retain as much independence as is practical in their lifestyles.
Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 11 Service Users were confident about expressing their opinions openly to the inspector and spoke about the home as a positive environment even when making negative observations. One Service User told the Inspector that he would like to go out more at night-times to clubs etc but the Inspector was informed by the Registered Manager that unfortunately this is not always practical. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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): 19, 20 Service Users are properly supported to maintain their health and personal care. EVIDENCE: Service Users expressed full confidence in the way in which they received support for their personal and healthcare needs. Staff enable appropriate support from community healthcare practitioners, and this is evidenced in records. The medication cabinet was not checked at this Inspection, but Service Users described the administration of medication by the staff at the home and reported that their medicines were always promptly available from staff in accordance with the homes normal routines. Staff confirmed the efficiency of the homes systems in relation to medications. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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): 22 Service Users are properly protected through an open atmosphere and the training and awareness of staff. EVIDENCE: Service Users who spoke with the Inspector were all confident that they were listened to and heard by staff. They were all able to name a member of staff that they would choose to go to with any concerns, but appeared equally confident to approach any staff member. The complaints log was not reviewed on this occasion. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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): 24, 25 The home is safe and generally comfortable and homely, given the disruption caused by the building work. EVIDENCE: Although there is ongoing building work there are havens of quiet and sanctuary within the premises. Service Users retain the use of comfortable homely and personalized rooms even when these are temporary accommodation whilst they await completion of their new improved rooms. Service Users expressed general satisfaction with these arrangements. Some new areas are now available to Service Users for use, such as the residents’ kitchen and the Service Users who use these facilities were happy with the area. All necessary facilities remain available for Service Users. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 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): 32,34 Service Users benefit from the support of a trained and committed staff team. EVIDENCE: Staff records were not reviewed at this inspection. The inspector discussed the recruitment process with a recently employed staff member. The process was described as very professional and supportive and the staff member was fully satisfied with the ongoing support and training that she had received at the home. Staff reported that they have regular training and supervision, and that these are useful and supportive. Service Users were highly complimentary and confident in individual staff and the overall support of the staff team. Several Service Users made comments to the effect that staff “couldn’t be faulted”. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 16 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 The management style and systems of the home support Service Users in attaining and maintaining a good quality of life. EVIDENCE: The Registered Manager is well supported by her Assistant Manager. Both have the Registered Managers award, and have commenced the National Vocational Qualification level 4, in care. Additionally, on the management team are an operations manager responsible for staff training and a programme manager responsible for some aspects of staff management and Quality Assurance. Service Users and staff both commented on the “open door” management style which enables good communication, and enhances the smooth running of the home. Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x x x x x Standard No 22 23 Score 3 x ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 x x x x Standard No 24 25 26 27 28 29 30
STAFFING Score 2 3 x x x x x LIFESTYLES Standard No Score 11 3 12 x 13 3 14 x 15 x 16 x 17 Standard No 31 32 33 34 35 36 Score x 3 x 3 x x CONDUCT AND MANAGEMENT OF THE HOME x PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Christchurch Court Score x 3 x x Standard No 37 38 39 40 41 42 43 Score 3 x x x x x x DS0000012742.V261056.R01.S.doc Version 5.0 Page 18 No 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. x Standard x Regulation x Requirement None made at this inspection Timescale for action 22/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. x x Refer to Standard Good Practice Recommendations None made at this inspection Christchurch Court DS0000012742.V261056.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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