Inspection on 23/05/06 for Community Care Solutions (Husbands Bosworth)

This inspection was carried out on 23rd May 2006.

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

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Community Care Solutions... 18/06/07

Community Care Solutions... 05/10/05

Similar services:

Hillside

Applegarth

Trevayler Residential Care Home

122 Scorer Street

Jubilee Villa Care Home

Thornham Grove

Beech Lodge

8 Thorndale Road (Homefield College)

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

CARE HOME ADULTS 18-65 Community Care Solutions (Husbands Bosworth) 27 - 29 High Street Husbands Bosworth Lutterworth LE17 6LJ Lead Inspector Mrs Moira Mosley Unannounced Inspection 23rd May 2006 09:00 DS0000064674.V296284.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 DS0000064674.V296284.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. DS0000064674.V296284.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Community Care Solutions (Husbands Bosworth) Address 27 - 29 High Street Husbands Bosworth Lutterworth LE17 6LJ 01858 881200 01858 881200 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) Community Care Solutions Limited Position Vacant Care Home 13 Category(ies) of Learning disability (13), Mental disorder, registration, with number excluding learning disability or dementia (13) of places DS0000064674.V296284.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. No additional conditions of registration apply. Date of last inspection 5th October 2005 Brief Description of the Service: Community care Solutions, Husband Bosworth is registered to provide care and support for up to thirteen people who have learning difficulties or who experience mental ill health. The home is on the main street in Husbands Bosworth, close to local shops, churches and pubs. There are bus routes nearby to Leicester and Market Harborough. Chapel Cottage has seven single bedrooms and three double bedrooms. There are two lounges - residents can smoke in one of them. There is also a dining room and kitchen. At the back of the house there is a small patio and garden area, which residents can use. The current fees are £326 per week. DS0000064674.V296284.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a statutory unannounced inspection by one inspector. The inspection process included the collation of information and pre-inspection planning to gather information and then four hours were spent in the home. The focus of inspections undertaken by the Commission of Social Care Inspection is upon the outcomes for residents and their views of the service provided. This is achieved primarily through the process of ‘case tracking’ which involves reviewing the care of specific residents including looking at their records, talking to them and their families or representatives where possible and talking with the care staff who provide the personal care to those selected residents. The care of two residents was reviewed on this inspection to include care plans, risk assessments, medication and other records. In addition four residents were met and although two had communication difficulties and were unable to fully voice their views they demonstrated their feelings about being in the home. Discussions were also held with two staff members and a period of observation undertaken. What the service does well: There is a positive approach to promoting independence and accommodating individual needs that include disability issues and the different cultural backgrounds of the residents with the environment set out and clear documents and policies written to meet the various needs. Recruitment procedures are good to ensure staff are employed with checks done to ensure they are suitable to work in this field. A newly appointed staff member confirmed a detailed induction process was in place and there was a good level of support to help staff settle in and learn about the residents and their needs. Residents spoken to were very positive about the staff and the home, comments included “they are helping me get my independence” and “ I can talk to them about anything”. Activities are good with some residents attending college and day centres, with others choosing to do individual programmes with staff support. The residents spoke about holidays and outings to parks, shops and pubs, which they really enjoy. DS0000064674.V296284.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: The care plans for residents did not always give sufficient information to ensure that needs are fully identified and for staff to be clear about what they need to do in a consistent way and a requirement has been made. This was the same for health care assessments, as some residents were identified as needing input for pressure ulcer care, diabetes or epilepsy although it was evident that any concerns are being referred to the appropriate professional, for example the GP, practice nurse and consultants there was a lack of documentation to tell staff what they needed to do and a requirement has been made. The personal care needs were again not detailed and it would be difficult for new or agency staff to know what to do, this could prevent residents receiving appropriate care and a recommendation has been made. It is evident that some areas of the home need updating and the acting manager confirmed the new company that owns the home have extensive plans to refurbish and redecorate the home, which residents were excited about but they are unsure of exactly what and when this is happening. This causes uncertainty and is unsettling for the residents. A recommendation has been made for the plans to be available in the home with expected timescales for works to be completed. Please contact the provider for advice of actions taken in response to this DS0000064674.V296284.R01.S.doc Version 5.2 Page 7 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. DS0000064674.V296284.R01.S.doc Version 5.2 Page 8 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 DS0000064674.V296284.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s would be fully assessed to ensure their needs could be met. EVIDENCE: There have been no new admissions to the home for the past eight years, however there are the necessary documents and procedures in place to ensure a detailed assessment process would be taken for any new admissions. The acting manager demonstrated a good understanding of the need for a detailed assessment and particular care would be taken to ensure any new resident was able to fit into the already established group and was clear about the level of experience of the staff team and has identified that training may be required before they were to take a new resident with different needs. The residents currently in the home have detailed assessments on a regular basis with care plans updated to reflect changes of need. DS0000064674.V296284.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7 and 9 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. The lack of documented care plans and cross-reference to risk assessments could put the residents at risk of not having their needs met. EVIDENCE: The residents said that the staff know them well and help them how they want to be helped. Discussions with the staff demonstrated that they do know them well and there are good communication systems in place to ensure any issues are handed over, however there is an over reliance on word of mouth for care practices. The care plans identify areas of need and goals to be aimed for with residents discussing these with their keyworkers and signing them to state agreement. However the level of detail in the care plans does not clearly direct staff as to what action they need to take to meet those goals. Examples included residents with needs identified with personal care, incontinence, epilepsy, diabetes and the use of a wheelchair, and although the goals were set there were no further instructions for staff on how to do these things. DS0000064674.V296284.R01.S.doc Version 5.2 Page 11 Discussions with the staff team and the residents evidenced that these were being addressed but not documented which could cause inconsistencies in care and make it harder for new staff and agency staff to met the needs. Within the care plans faith and culture are addressed with needs identified and action needed identified for example church attendance. It was evident through observation and discussion with residents and staff that people are enabled to make their own decisions. For example one resident spoke about her daily activities and she liked that she could choose what to do and when to do it. Detailed risk assessments are in place for any identified risk, however these are not then cross-referenced to the care plans to show what action is needed to minimise the risk. An example was one resident who had a risk assessment for diet, which indicated the need for monitoring of weight and referral to dietician if concerned. There was no reference to dietary needs within the care plan although there was a weight chart but no direction a to how often she should be weighed or what would be considered a concern. DS0000064674.V296284.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are encouraged to be as independent as possible with a good range of leisure activities available that enable them to lead full and active lives. EVIDENCE: The residents attend a variety of day placements including college, day centres and individual activities to suit their needs. Staff confirmed that they work with the residents to encourage activities both on an individual and small group basis. They have good links with and are active within the local community and access local facilities and services. The staff confirmed and documentation evidences good family and friends support within the home with frequent visits, home visits and telephone contact to keep in touch. Relationships between service users and staff were positive; staff encouraged and enabled service users rather than taking over and controlling what they were doing. DS0000064674.V296284.R01.S.doc Version 5.2 Page 13 Menus show that a range of nutritious meals is offered to residents. Residents are given choice about what they want to eat and the menus are discussed as part of their meetings. One resident spoken to was supported to prepare her own snacks and enjoyed regular baking sessions, she also chose not to have the lunch on offer and went to the shop to purchase what she fancied for lunch. Residents said that they like the food in the home. DS0000064674.V296284.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 and 21 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to this service. Residents’ health care needs could be better met with more detailed plans of care. EVIDENCE: Staff spoken to were able to confirm which residents needed help with personal care, however the care plans only state if residents are either fully independent or need total help - there is a lack of documented direction for staff or detail about what care has been given. Healthcare needs are documented and there was good evidence of liaison with healthcare professionals including GP, practice nurse, dental, optical and podiatry services. As identified above, again the care plans do not give sufficient direction for staff to met the needs and this was also evident within healthcare needs for example diabetes, epilepsy and pressure ulcer care – it was evident that the necessary professionals were involved and those needs were being met but no specific instruction for staff on what their role was. There are medication procedures in place for the safe ordering, storage, administration and disposal of medication. The medication administration records were cross-referenced to the medication stored for three residents. DS0000064674.V296284.R01.S.doc Version 5.2 Page 15 One resident had two extra tablets when audited, despite them being signed for as given on the records. The manager agreed to investigate this further; all other tablets counted matched the balance recorded. One resident spoke about their wish to try and self medicate, the acting manager spoke about the concerns they had however agreed to discuss this further with the resident and risk assess to see if they could begin to move towards self medication, they do have a policy for this process. The wishes of the resident in regard to illness, dying and death are recorded within their care plans with evidence of discussion with their key workers about who they would want to know if they were ill and detailed directions on choices of funeral arrangements. . DS0000064674.V296284.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is an effective system for the home to respond appropriately to complaints made and residents are protected from abuse with their views listened to. EVIDENCE: The complaints procedure is available in a variety of formats to suit different needs. The staff were aware of the complaints process and would support the residents in raising concerns through the keyworker system. The residents spoken to were very clear about who they would speak to if they had any concerns and their interactions with the staff demonstrated very open and relaxed relationships with the residents encouraged to make their points of view heard. There have been no complaints or allegations made since the last inspection. Training records demonstrated and staff confirmed they have all received training on the protection of vulnerable adults and demonstrated a good understanding of the need to protect residents and what to do if they had any concerns. The resident spoke to said they felt safe living in this home. There is an effective system in place for the management of resident monies and some have their own bank accounts, with them being supported and encouraged to manage their own budgets as independently as possible. DS0000064674.V296284.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a safe environment for residents to live but further information about proposed changes should be available to reassure residents. EVIDENCE: There is a maintenance system in place to ensure repairs are carried out, fire records showed regular checks to ensure it was a safe environment. The environmental officer visited in May 2006 and there were no issues of concern. There are areas that need updating and redecorating and it is planned for the home to undergoing significant refurbishment to update the premises. At present there are six vacancies as bedrooms are being updated prior to any new admissions. The residents spoken to were excited by the planned changes but were concerned at what exactly was going to happen and when. It was discussed with the acting manager that a plan for the proposed changes should be available with timescales to demonstrate to and reassure residents about how long this would take and when changes would happen. DS0000064674.V296284.R01.S.doc Version 5.2 Page 18 The grounds are well maintained and give accessible space for the residents to use at any time. The home was clean in all areas and the laundry systems are effective. DS0000064674.V296284.R01.S.doc Version 5.2 Page 19 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 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Suitably qualified and trained staff are provided in adequate numbers to ensure resident needs can be met. EVIDENCE: Staff training records demonstrated that staff have received the training needed in order to perform effectively within their roles. All staff are currently up to date with statutory training There is a detailed induction process in place to ensure new staff receive sufficient information before fully undertaking their role unsupervised. A new member of staff spoken to confirmed this. Some staff have achieved their National Vocational Qualifications (NVQ) at level 2 or above, with all others booked to commence this training during 2006. There is now a rolling programme of training to ensure staff are kept up to date and given the opportunity for new training. Staffing levels are being maintained at a safe level, there are currently seven residents with a minimum of two members of staff on duty. Both the staff and residents spoken to said these were sufficient numbers to meet needs and give time for activities and one to one time with residents. DS0000064674.V296284.R01.S.doc Version 5.2 Page 20 There has been a recruitment drive and the home is now fully staffed with minimum use of agency staff, which was a concern on previous inspections. Recruitment procedures are good with evidence in staff files of a comprehensive system including references to ensure staff are suitable for the post and Criminal Record Bureau (CRB) checks, to check that staff don’t have any past criminal records or other reasons why they should not work in care with vulnerable people, prior to commencement of employment. DS0000064674.V296284.R01.S.doc Version 5.2 Page 21 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a proactive management approach to address issues identified and residents’ views are being sought with working practices in place to ensure that the health and safety of residents is promoted and protected. EVIDENCE: The acting manager was the owner of this home for eleven years prior to the sale in 2005 to the current organisation and she is in the process of applying to the CSCI for registration as the registered manager. She demonstrates a good understanding of the role and has the necessary experience and training to meet the needs of the residents and the home. The staff spoke highly of the management of the home and it was evident through observations of the positive relationship between the residents and the staff team including the manager. There are regular meetings with residents and the residents are supported and encouraged to be involved in the running of the home as far as possible. The DS0000064674.V296284.R01.S.doc Version 5.2 Page 22 organisation that owns the home conducts regular questionnaires and gives feedback to the home of results and any areas that need improvement. Staff training records demonstrated that staff are currently up to date with statutory training. There are effective systems in place for health and safety issues to be addressed and there were no concerns identified at the time of this inspection. Fire records were seen and showed there were regular tests and there is a system in place to ensure maintenance is kept up to date. DS0000064674.V296284.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 2 2 3 3 3 X 3 X X X 3 DS0000064674.V296284.R01.S.doc Version 5.2 Page 24 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. 1. Standard YA6 Regulation Requirement Timescale for action 30/07/06 2. YA19 12(1)15(1) Care plans must identify all areas of need and give clear direction of action required to meet those needs. 12(1)(b) Healthcare needs for example pressure ulcer care; diabetes or epilepsy must be identified within the care plans and give clear directions for action to be taken. 30/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. Refer to Standard YA18 YA24 Good Practice Recommendations Personal care needs of residents should be detailed within the care plans The refurbishment programme should be available within the home with timescales for works to be completed. DS0000064674.V296284.R01.S.doc Version 5.2 Page 25 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 © 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 DS0000064674.V296284.R01.S.doc Version 5.2 Page 26 - 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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