Inspection on 21/11/06 for Conifers

This inspection was carried out on 21st November 2006.

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

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

Other inspections for this house

Conifers 09/09/08

Conifers 20/03/06

Conifers 28/09/05

Conifers 14/03/05

Conifers 06/10/04

Conifers 31/03/04

Conifers 08/01/04

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 Conifers Harriets Farm Bungalow Church Street Bocking Braintree Essex CM7 5LH Lead Inspector Brian Bailey Key Unannounced Inspection 21st November 2006 12:10p Conifers DS0000017958.V320962.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 Conifers DS0000017958.V320962.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. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conifers Address 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) Harriets Farm Bungalow Church Street Bocking Braintree Essex CM7 5LH 01376 550779 01376 550779 Mr Upul Saliya Sumaranayake Mr Upul Saliya Sumaranayake Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 20th March 2006 Brief Description of the Service: Conifers is a detached bungalow situated in a quiet residential area on the edge of Bocking village. This home accommodates 6 people who are between the ages of 18 and 65 years of age who have learning and physical disabilities. The registered owner and manager is Mr Sumaranayake. Residents’ private rooms are for single occupancy. The home has a large private and well-maintained garden at the rear of the property and ample car parking facilities at the front. There is a local shop and local transport, the centre of Braintree being only a short distance away. The home also has a mini bus, which is in use daily. As at 21st November, the manager stated the fees as being £850 per week and extras to the fees include hairdressing and toiletries. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was a key inspection looking at the core standards for care for adults. This report is based on a range of information that has been accumulated from our inspection records, a site visit to the home that took place on 21/11/06 between 12:10 and 17:15, discussions and observations with residents, staff, the manager, questionnaires issued by CSCI and the records kept at the home. Comment cards were returned from relatives and all indicated they were satisfied with the service provided. What the service does well: What has improved since the last inspection? What they could do better: An up to date and comprehensive statement of purpose or information booklet would benefit prospective residents and their families, and assist them with gaining information about the home and the services provided. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 6 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. Conifers DS0000017958.V320962.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 Conifers DS0000017958.V320962.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, 3 and 4. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective residents can be certain that assessments of need will be carried out to help determine whether the home will be able to meet their needs, but a lack of available clear information about the services provided limits peoples ability to make decisions about the suitability of the home. EVIDENCE: Apart from one person, five residents have lived at the home for between five and ten years. From observation and discussion with the manager, staff and a check of the care records, it was apparent that the manager and staff considered the home was able to meet residents’ needs. Evidence was available to show that staff had visited the most recently admitted resident. Care records showed that the purpose of such visits was to assess the persons needs and to try to establish whether they would be compatible to live with the existing residents. This was essential in the most recent case as it was considered unwise for the person to make a trial visit, which would be the normal procedure. Assessment of each person’s needs is an ongoing process and any changes are recorded and dated. The home did not have a statement of purpose available for inspection although a pictorial service user guide was seen. The manager stated that Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 9 these documents had not been requested by the placing authority or the relatives of the most recently admitted resident. Conifers DS0000017958.V320962.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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a consistent care planning system in place and the health and social needs of individuals are set out in their plans. Residents are encouraged to make decisions about their lives. Risks are seen to be part of decision making and planning for individuals. EVIDENCE: The care records of two residents were looked at. These showed that they are detailed, up to date and reviewed at regular intervals. Care records of the most recently admitted resident were in the process of being created as staff gradually learn about the needs of the person in more depth and can compare with the original assessment. Individual records showed that the health care needs were being addressed. A variety of guidance notes were available for staff to understand procedures. Conifers DS0000017958.V320962.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): 11, 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. Personal support is offered to promote dignity and independence. A range of opportunities for social, leisure and educational pursuits are offered and a well balanced diet is provided. EVIDENCE: On the day of inspection, four residents returned at lunchtime having spent the morning at Witham engaged in various activities. Lunch had been prepared in their absence by the staff member who had remained at the home with two residents. They were welcomed home and given the necessary assistance to prepare for lunch, which was fish and chips. The meal appeared appetising, and residents spoken to indicated they liked the meal and that they do enjoy all meals. There were good stocks of food in the kitchen and plenty of fresh milk. Staff were observant during the meal and offered assistance as required. Menus were seen and staff said that residents tended to have the same meal as they were aware of any likes and dislikes. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 12 During the afternoon, three residents went out in the mini bus for activities at a Braintree community centre. Staff occupied the residents that remained at home. From discussion with staff, observation of records and looking at photographs with residents, it was evident that the home enables all residents to access facilities in the community. Staff said they thought the residents enjoyed an active life; that the home was fun and they liked working at the home. Conifers DS0000017958.V320962.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 – 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Medication is administered in line with policies and in a way that safeguards residents. Residents receive support in the way they prefer and require. Their physical and emotional care needs are understood and met. EVIDENCE: Care plans indicate the support that residents require and how this could be given in a way that they prefer. Residents spoken with said they liked living at the home and were happy with the way they were cared for by the staff. Care plans and other records showed that that service users health needs were given a high level of priority by the home staff. All medication is kept in a locked cupboard. The Medicine Administration Record sheets were checked and found to be up to date. Staff have received training on medicine administration, use and side effects. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 26 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has appropriate arrangements in place to protect residents and to respond to their concerns. EVIDENCE: The home has a complaints procedure. No complaints have been received by CSCI or the home since the last inspection. Residents spoken with said that they would speak to any of the staff if they were unhappy about anything. From observation, residents were relaxed and looked at ease in the company of staff. The home has an adult protection procedure and had copies of the Essex Vulnerable Adult Committee guidelines. The manager stated that all staff had received training on the protection of vulnerable adults from abuse. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 28 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment within the home is good providing the residents with a homely place to live. There is a good standard of maintenance. EVIDENCE: The home is ideally suited to residents’ needs and is situated in a quiet area of Bocking village. It continues to be well maintained and is decorated and furnished to a good standard that creates a homely, comfortable and welcoming appearance. There is a lounge/dining room that overlooks the rear garden. Residents’ bedrooms looked homely and individual in style. They had been encouraged to personalise them with their own possessions. Residents spoken to said they liked their rooms. The building was clean, appropriately heated and free from unpleasant smells. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 16 The kitchen was clean, tidy and well equipped and there were good food stocks available. Residents were observed to make use of the kitchen. Conifers DS0000017958.V320962.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 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Recruitment practices are consistent and appropriate checks are carried out. Staff are competent and individual needs are understood and met as are those of the group. EVIDENCE: Evidence was available on individual staff files to show that staff had been recruited appropriately and attended training. Training certificates were available. The home has a wide range of training tapes available. A folder was available, which showed individual training records covering the relevant training topics that staff require. Four staff had obtained a National Vocational Qualification (NVQ) at level 2, one person has a nursing qualification and two staff are working towards a NVQ 3. From observation and discussion with staff they were knowledgeable about residents and demonstrated patience and respect. Staff confirmed that they had received various training sessions including the protection of vulnerable adults, food hygiene, first aid and moving and handling. Several staff were due to attend a training session the following day on communication techniques. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 18 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 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. This home is well managed and maintained to ensure the safety of residents. EVIDENCE: The manager/proprietor is closely involved in the day-to-day work within the home. The home has issued quality assurance questionnaires during the past two years to relatives and is due to send out questionnaires for this year. The opportunity should be taken to obtain the views of as many people as possible that have interest in the welfare of the residents. Evidence was available to show the home takes the necessary precautions regarding health and safety matters. All equipment and systems were being serviced at the appropriate intervals and were up to date. All staff had received training in the basic health and safety requirements that include infection control, first aid, moving and handling and food hygiene. Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 19 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 2 3 3 3 4 3 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 3 25 3 26 3 27 X 28 3 29 3 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 3 3 X 3 X LIFESTYLES Standard No Score 11 3 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Conifers DS0000017958.V320962.R01.S.doc Version 5.2 Page 20 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 YA1 Regulation 4&5 Requirement The registered person must ensure an up to date statement of purpose and service user guide are available for residents and relatives. Timescale for action 01/02/07 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 YA41 Good Practice Recommendations It is recommended that service user’s records are streamlined to make files more manageable and easily accessible. 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