Inspection on 22/06/05 for Conquest House

This inspection was carried out on 22nd June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Conquest House 05/12/06

Conquest House 25/04/06

Conquest House 29/11/05

Conquest House 14/12/04

Conquest House 27/07/04

Similar services:

Chesham House

Argyll House

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

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

CARE HOME ADULTS 18-65 Conquest House Straight Drove Farcet Cambridgeshire PE7 3DY Lead Inspector Matthew Bentley Unannounced 22 June 2005 @ 12:00 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 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 Stationary 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. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Conquest House Address Straight Drove Farcet Cambridgeshire PE7 3DY 01733 244623 01733 245845 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Conquest Care Homes (Peterborough) Limited Marie Brown Care Home 20 Category(ies) of Learning disability (20), Mental disorder, registration, with number excluding learning disability or dementia (20) of places Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 14 December 2004 Brief Description of the Service: Conquest House provides support and accommodation for up to 20 younger adults with a learning disability which may be coupled with a mental disorder. Some service users have complex needs including behaviours which challenge the service. The home is in a converted vicarage near to the Fenland village of Farcet. An additional bungalow on the same site provides care and support for up to six permanent residents, however, at the time of the inspection there were no residents and the building was being used to provide day services to some of the residents of the house. In addition to day support staff there are two waking night staff to assist residents when necessary. A cook, cleaner and maintainance person are also employed. The home is owned by Parkcare Homes (No.2) which is a trading subsidiary of Craegmoor Group Ltd; Conquest Care Homes (Peterborough) Limited continues as the registered provider. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of Conquest House, for the period 2005/6. The unannounced inspection took 4.0 hours and took place between 12.00 and 16.00. On the day of inspection a number of service users were at home and the inspector spoke to six individuals. The inspection also included reading documents, speaking to staff and the acting manager (the registered manager being on maternity leave), and a tour of the home. What the service does well: What has improved since the last inspection? Since the last inspection the atmosphere in the home has become noticeably calmer and feels more homely. Staffing ratios have been improved and the home no longer relies on agency staff to supplement the permanent staff team. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 6 The home has increased the range and number of vehicles to enable easier access to facilities outside the home. One member of staff (who left the home approximately a year before) had recently resumed employment and commented favourably on the overall improvement to the home, the level of training, and the quality of the food. 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. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 1,2,3,4,5 Information is available to help prospective service users make an informed choice about whether the home is suitable for them, and appropriate measures are in place to allow visits prior to their making a decision. Staff know each service user as individuals and have helped each to work towards achieving and identifying goals, and the home is supported by healthcare professionals. The home’s contract does not show the room to be occupied, meaning that people could, in theory, be moved from one room to another without being properly consulted. EVIDENCE: The home had a statement of purpose, which outlined the services, that people using the service, or considering it, could expect to receive. The document had been updated since the last inspection so that it would meet the requirements of the relevant standard and regulations. The acting manager said that most referrals came from care managers or other professionals, and potential residents would be visited prior to admission in order to make sure that the home would be likely to meet the needs of the person concerned. Assessment information relating to a number of people was seen and showed that the acting manager and other staff had done a full assessment of the needs of potential residents including getting information from professionals and families, and also watching how people were supported in their existing placements. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 9 Staff spoken to have the knowledge and skills to work with people with a learning disability, and are appropriately skilled and experienced. The acting manager said that healthcare professionals were very supportive and had regular contact with the home. People who are interested in the home are offered visits and a trial period during which they can decide whether the home is suitable and whether they want to stay. Residents are given a contract between themselves and the home, but the document needs to be updated to show which room is to be occupied. This was a requirement resulting from the last inspection; failure to comply with the requirement made from this inspection may result in legal action being taken against the service. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 6,7,8,9 Systems of care planning are clear and well laid out and contain information to guide staff about how to support those living in the home. Residents are involved in making decisions about their lives to the best of their abilities with help and guidance from staff when necessary. Systems for assessing risk are effective so that any unnecessary or unacceptable risks can be eliminated. EVIDENCE: The care plans relating to two of the people living in the home were seen and contained good quality information about what help each person needed and how it should be given. Reviews of care plans take place every month to make sure they are up to date. Discussions with the acting manager and staff members indicated that they have a good understanding of residents’ right to make decisions and to take acceptable risks. An assessment of the risk that might exist in a number of areas relevant to each resident has been carried out. Ways in which the risk might be avoided or lessened have been recorded and appropriate action has been taken to avoid unnecessary risk. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 11 Participation in the running of the home is promoted by offering choice and encouraging comments from those living in the home, both on a day-to-day basis, and through regular residents’ meetings. Residents are encouraged to do jobs abound the house that they enjoy, and are able to do. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 12,13,14,15,16,17 Staff provide appropriate support to facilitate contact with family and friends, and service users have access to leisure activities in the community, that are appropriate to their needs and abilities, however, the home’s location means that contact with the community has to be planned and necessitates the use of a vehicle. Service users are offered a healthy diet and are involved in choosing the menu and buying the food. EVIDENCE: The majority of residents take part in a range of activities to suit their individual needs and interests including leisure activities and educational courses at local colleges; however, the home’s location means that informal contact with the wider community is difficult to maintain. Some activities are provided by specialist day services, others involve going out with staff members. The home has it’s own vehicle so that those living at the home can go out singly with a member of staff, or as a group; staff members’ own cars are also occasionally used. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 13 Each resident has a specific member of staff to act as ‘key-worker’. Part of their tasks are to help maintain links with families at an appropriate level. Residents meetings take place regularly to give each person the opportunity to say what they think about the service and make suggestions about things such as food or outings that they would like to happen. The home employs a cook, and meals are planned at varying times depending on what is going on. The cook regularly attends residents’ meetings and asks for ideas about what meals people would like to be provided; she also involves residents in doing the shopping at the supermarket allowing them to assist with choosing what to buy. Fresh fruit is available and residents and staff spoken to commented how much the quality of food had improved since the cook had been employed. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 18,19,20 Care is provided in a manner that suits those living in the home, and service users physical, emotional and health needs are being met. Arrangements for the administration of medication are appropriate and the home’s procedures were being followed ensuring that service users were not put at risk. Storage of medication, especially eye drops, needs to be improved. EVIDENCE: Staff were helping people appropriately with a range of tasks and those spoken to appeared knowledgeable about individuals’ needs and how they should provide help and support. Help with dressing and other aspects of personal care is carried out in private in individuals’ rooms or in the bathrooms. The home is supported by specialist learning disability professionals including psychiatrists, occupational therapists, care managers, nurses, and speech and language therapists. Medication records were inspected and were complete, and accurate, and the person responsible for medication said that she had had training to make sure she was able to safely give out medication. The systems for administering and storing medication were well organised, however, records showed that over recent days the temperature in the medication cabinets had been more than Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 15 30oC, which is higher than medication, especially eye drops and other perishable items, should be stored. A requirement has been made about this, however, whilst the inspection was taking place the acting manager ordered a suitable fridge to store medication. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 22,23 The home’s systems for dealing with complaints are satisfactory, as are the arrangements for ensuring the protection service users from neglect or harm. EVIDENCE: The home has a policy and procedure to follow if a person wishes to make a complaint about the service; the procedures are displayed on the wall in the entrance hall. Some amendments were needed to update the contact details for the Commission; these were done whilst the inspection took place. The home has a procedure to ensure the protection vulnerable adults and has a ‘whistle-blowing’ policy detailing action staff should take if they have concerns about mistreatment of service users. Staff confirmed that they know about the procedures to be followed if they are worried that someone might have been mistreated or abused, and said that they would be able to talk to a senior member of management and were confident that they would then take the appropriate action. Records relating to service users’ money were seen and were in order. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 standard(s) 24,27,30 Though it is clean and generally adequately maintained, the location, layout and facilities of the building means that it is unsuitable for the needs of those living in the home. EVIDENCE: The location of the home means that it is could not be seen to be part of the local community, and service users are dependant on staff to transport them to local amenities. The communal areas of the House are maintained and decorated to an acceptable level, and work has continued to improve the environment generally. Thermostatic valves have been fitted to sinks and baths to ensure that hot water is delivered at a safe temperature. The large bathroom has a separate shower that has been out of use for many months and which has no curtain round the tray; there are also a number of tiles that are cracked or broken. Staff spoken to said that they wished the home had a shower for people to use, especially in the hot weather. The bath in the small downstairs bathroom was chipped and worn and was in need of replacement. A requirement was made about these matters following the last inspection; these have not been met. Failure to comply with these requirements may result in legal action being taken against the service. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 18 On the day of inspection the home as a whole was found to be clean and hygienic, however, there was a noticeable smell of urine in the lounge. The acting manager said that he was aware of this and it was caused by a problem with one particular resident, however, he would make continued efforts to make sure that the smell was eradicated. A requirement has been made about this. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,33,34,35,36, The home has a staff team which meant that service users’ needs are properly met. Staff are clear about their roles and were properly trained, competent, and appropriately experienced, and appropriate checks were being made prior to the appointment of new staff. EVIDENCE: It was clear from watching how they worked with the residents, that staff have built professional, warm and friendly relationships with residents. Staff were clear about what they were there to do and how they should be providing help and support, and all those spoken to were well presented and welcoming, and demonstrated a high level of knowledge, experience, and professionalism. A range of training has taken place including essential health and safety training such as food hygiene and first aid. The acting manager said that soon all the senior staff will have done an in depth first aid training course and all would be fire marshals. All of the staff team either have, or are doing, a National Vocational Qualification (NVQ) in care, and the cook and cleaner are doing a relevant NVQ. One of the staff members spoken to said that she had received more training at the home than in any other home she had worked in. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 20 In addition to the manager, administrator and cook, five staff were on duty at the time of inspection, and those spoken to said that that was enough to allow them to properly meet each person’s needs. Since the last inspection staffing has improved and agency staff are now rarely used. A number of new people have recently been recruited, and references, Criminal records Bureau (CRB) checks, and other necessary documents are being obtained before the people concerned start work. Staff confirmed that they feel well supported in their work and receive adequate and effective supervision, in the form of a Personal Performance Agreement, from the acting manager. Staff meetings are held regulary and include an update on each of the service users’ needs, matters of health and safety, and any other areas of concern. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,39,42 The home is properly managed and in the absence of the registered manager, the acting manager is providing good leadership and guidance to staff. Quality assurance systems are in place, but the findings are not shared with the home so any deficit was not being highlighted. Training is in place to ensure that staff are able to work safely. EVIDENCE: The registered manager is on maternity leave, however, the acting manager is running the home competently and effectively in her absence and is beginning working towards gaining the Registered managers’ Award (RMA). The acting manager said that a questionnaire was sent out to service users and/or their representatives to give them the opportunity to air their views about the quality of the service, however, the results of these surveys were not being shared with service users or the home. This was a requirement resulting from the last inspection; failure to comply with this requirement may result in legal action being taken against the service. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 22 Health and safety training is included in the induction of new staff and training is provided to update staff as necessary. Staff spoken to said that they had been given enough training to allow them to do their work safely, this includes training in avoiding and dealing with challenging or aggressive behaviour. One of the covers on the radiator in the upstairs corridor was missing; the acting manager said that it had been pulled off by a resident, but was due to be replaced shortly. A requirement has been made about this. Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 4 2 Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 3 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 1 x x 1 x x 2 Standard No 11 12 13 14 15 16 17 x 3 2 3 3 3 3 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Conquest House Score 3 3 2 x Standard No 37 38 39 40 41 42 43 Score 3 x 2 x x 2 x I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 24 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 5 Regulation 5(1)(b)(c) Requirement Each service user must be provided with a written contract/statement of terms and conditions containing the information required to meet this standard and associated regulations This was a requirement resulting from the last inspection; failure to comply with this requirement may result in legal action being taken against the service. Eye drops and other perishable medication must be kept securely in a refrigerator. The bathroom suite referred to must be replaced and effective heating must be provided This was a requirement resulting from the last inspection; failure to comply with this requirement may result in legal action being taken against the service. The shower in the large bathroom in the house must be repaired or replaced, suitable screens or curtains must be provided. This was a requirement resulting from the last inspection; failure to comply with this requirement may result Timescale for action By 15 August 2005 2. 3. 20 27 13(2) 23(2)(j) By 15 August 2005 By 31 August 2005 4. 27 23(2)(j) By 31 August 2005 Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 25 5. 30 16(2)(k) 6. 39 24 7. 42 23(2)(b) in legal action being taken against the service. The premises must at all times be kept free from offensive odours. This was a requirement resulting from the last inspection; failure to comply with this requirement may result in legal action being taken against the service. Effective quality assurance systems based on seeking the views of service users and their representatives must be put in place, and the findings must be made available to service users and the Commission This was a requirement resulting from the last inspection; failure to comply with this requirement may result in legal action being taken against the service. The radiator covers referred to must be securely fixed to ensure service users’ safety From the date of this inspection (i.e. 22 June 2005) and ongoing By 31 August 2005 By 15 August 2005 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 Good Practice Recommendations Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 26 Commission for Social Care Inspection CPC1, Capital Park Fulbourn Cambridge CB1 5XE 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 Conquest House I53I03 15146 CONQUEST HOUSE 232830 2206205 STAGE 4.doc Version 1.30 Page 27 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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