Inspection on 25/04/06 for Conquest House

This inspection was carried out on 25th April 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 there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 8 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Conquest House 05/12/06

Conquest House 29/11/05

Conquest House 22/06/05

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 Andy Green Unannounced Inspection 25th April 2006 10:00 Conquest House DS0000015146.V288204.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 Conquest House DS0000015146.V288204.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. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Conquest House Address Straight Drove Farcet, Cambridgeshire PE7 3DY 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) 01733 244623 01733 245845 Conquest Care Homes (Peterborough) Limited Care Home 20 Category(ies) of Learning disability (20), Mental disorder, registration, with number excluding learning disability or dementia (20) of places Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. MD only in association with LD Date of last inspection 29th November 2005 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 it was empty and the building was being decorated in preparation for the admission of new residents. In addition to day support staff there is one waking night staff with another staff member sleeping in the building to assist residents if necessary. A maintenance person is also employed, though there is a vacancy for a cleaner, and a cook, the later of who has taken on the post of support worker. The home is owned Craegmoor Group Ltd; Conquest Care Homes (Peterborough) Limited is a subsidiary of the organisation, and continues as the registered provider. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Andy Green and Matthew Bentley, Regulation Inspectors, conducted an unannounced key inspection on 25th April 2006. They met with the Deputy Manager, care staff and service users to gather views regarding the services offered in the home. A number of records were inspected including care plans, training records, activities records and medication administration records. A tour of the communal parts of the home and some bedrooms was also undertaken. A subsequent visit to the home was made on 22nd May 2006 and the inspection concluded with a meeting on 27th June 2006 with the manager and providers to review concerns raised at the site visit. What the service does well: What has improved since the last inspection? During the inspection dates the manager has been appointed to the post of manager. Recording in daily notes has improved Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Conquest House DS0000015146.V288204.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 Conquest House DS0000015146.V288204.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,5 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Prospective service users have access to information, and can make an informed choice regarding the home’s services. EVIDENCE: A full assessment of each prospective service user is made to ensure that the care and support can be met. Information is gathered from healthcare professionals and when appropriate, families are involved in the assessment process and are invited to be part of the reviews of the placement. Since the last inspection a contract between the home and service users has been devised, however, it does not detail room numbers or the period of notice that is required. It was clear from discussions that one of the service users should be reassessed as his diagnosis is unclear and it is uncertain whether the home is meeting his needs. The manager is ensuring that the local healthcare team carry out a re-assessment. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 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): 6,7,8,9,10 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Care plans are in place but need improving to ensure that the home can meet each individual service user’s assessed needs. EVIDENCE: The care plans relating to four of the people living in the home were seen but contained limited information about what help each person needed and how it should be given. Some of the care plans had been reviewed but some were overdue. Each service user continues to have a ‘key worker’, with another named staff member taking over if their main key worker is not on duty. The daily recording of the activities in which service users have been involved showed some improvements. However the current care planning process needs to be reviewed and the manager is currently developing A “Person Centred Plan” to give a more holistic approach and involves the service user as much as possible to ensure they can maximise their choice and independence. The risk assessment Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 10 process is also being reviewed and redeveloped to ensure that service users are protected from harm. Service users are encouraged to participate in domestic chores and jobs around the house where able. Discussions with the staff members indicate that they have a good understanding of service users’ right to make decisions and to take acceptable risks. The home has a policy to guide staff regarding what information should be shared, and with whom. Records containing personal information are kept securely in a filing cabinet in the office. Conquest House DS0000015146.V288204.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. Service users have access to activities in the home and wider community. A range of age appropriate activities are provided . Service users are provided with an adequate diet. EVIDENCE: The majority of service users continue take part in a range of activities to suit their individual needs and interests educational courses at local colleges; however, the home’s location means that informal contact with the wider community continues to pose difficulties without the use of vehicles. The activities co-ordinator is improving the range and frequency of the activities provided, including horse riding, swimming, and a range of sports, part of the aim of which is to improve service users’ fitness and health. Some activities are provided by specialist day services, others involve going out with staff members; a number of service users are enrolled on courses at the adult education colleges in Peterborough. During the inspection a number of service users were engaged in a lively football match in an area of the rear gardens. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 12 Service users meetings take place regularly to give service users an opportunity to give their opinion regarding the service and make suggestions about meals provided or outings that they would like to happen. Two new vehicles have recently been purchased which has improved availability for service users to access the community. Hot and cold drinks are always available and service users said that the food is good. Menus are agreed with service users and choices are given to accommodate individual preferences. Conquest House DS0000015146.V288204.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Service users receive appropriate health and personal care to meet their assessed needs together with support in taking prescribed medication. EVIDENCE: Staff were appropriately helping people with a range of tasks and those spoken to displayed knowledge regarding individuals’ needs and how they provide help and support. The home is supported by specialist learning disability professionals including psychiatrists, occupational therapists, care managers, nurses, and speech and language therapists; advice has also been gained from a dietician regarding the needs of one particular service user. Medication records inspected were satisfactory. Conquest House DS0000015146.V288204.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home has a satisfactory complaints process to make sure that service users have their complaints or concerns listened to and acted upon properly. 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. Service users said that they would speak to staff members if they were unhappy about the service. Conquest House DS0000015146.V288204.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,27,30 Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to the home. The environment is generally suitable for the needs of those living in the home. There is however a need to improve the décor and fittings provided in the home. Attention is also required to the exterior of the building and areas of the grounds, which have become overgrown. EVIDENCE: The communal areas of the house are generally maintained but decoration needs to be improved and there are a number of areas that need attention, Kitchen • The kitchen flooring needs replacing as it stained and worn • The fridge door handle is broken and needs to be repaired/renewed • The broken dishwasher needs to be removed and replaced with a new one or repaired • Areas of tiling near the light switch and cooker in the kitchen are damaged and need refurbishment • The walls in the kitchen are stained and scuffed and need redecorating Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 16 Downstairs WC • The flooring needs to replaced as it stained and worn • A pullcord needs to be reattached • A suitable window cover needs to be installed Downstairs bathroom • New flooring needs to laid as it stained and worn • Areas of missing tiling need to be replaced • Pipe work needs to be covered Upstairs bathroom • Areas of paintwork need to be finished • A suitable window cover needs to be installed Bathroom/Shower • Shower curtain needs to be in place • Complete redecoration needs to be undertaken including the removal of the unsightly panels on the wall • Bath panels need to be installed • Light fitting is inappropriate Bedrooms • Rooms 4 and 5 both have no doors following an incident with a service user. This poses a significant fire risk. • Room 14 decoration is now showing signs of deterioration and also needs a light shade installing Fire Doors • The fire door near the smoking area have clear plastic panels installed which needs replacing with appropriate glass panel • Another fire door in the same area had a hardboard panel in place which must be replaced with a suitable glass panel • A number of doors were not closing effectively including the door on the middle of the first floor • The deputy manager was advised that the local Fire Safety Officer should be contacted to carry out an audit in the home to ensure that service users are protected from potential harm. Exterior of premises • An area of brickwork around the exterior oil tank is loose and poses a potential hazard. This needs to be taken down or adequately secured • The bedding areas in the gardens need attention as they are overgrown with nettles Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 17 • • • A number of pathways around the premises are uneven and need attention which may pose a problem for service users who have mobility problems The exterior of the home is in need of redecoration in a number of areas including the entrance to the side of the building Areas of guttering need attention as grass or weeds were growing out of them Other areas of concern • The area of damp in the corner of the main staircase needs attention and redecoration. • There are a number of areas of paintwork, which have been ‘touched up’ in various areas of the home, which gives a poor impression, as the colours have not always been matched properly. • The service users need to be consulted regarding décor in the home as there are areas in the lounge and decorations to the front door which were undertaken without consultation Tables and seating have been replaced in the dining room with more durable items from another home in the same organisation. The home has an adjacent bungalow called Alpine Lodge, which is part of the same registration. At present it is not in use. The deputy manager stated when it returns to use it will have its own staff group who will be supervised by the manager. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 18 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): 32,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. Mandatory training is provided for care staff but there is little in the way of client specific training. however, formal one-to-one supervision is not taking place as regularly as is required. EVIDENCE: There were 7 staff on duty during the inspection. There is a process in place to ensure that new staff receive an induction to the home so that they are aware of procedures and policies. New staff shadow established staff during their induction to gain insight into how staff and service users interact whilst assisting with care and support. Health and safety topics are also covered during this period, as are the service’s values and ethos. Three members of staff were interviewed during the inspection and they confirmed that had received mainly mandatory courses eg fire safety moving & handling, first aid, medication administration and food hygiene. Two members of staff stated that they had received training in mental health awareness and POVA. Through conversations with the staff it was clear that that they had not received specific training related to the complex care and support needs of the current service users. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 19 The majority of the staff team either have, or are continuing to work towards NVQ in care at level 2 and 3. Staff spoken to stated that there is sufficient staff but there have been occasions when, due to vacancies, they have had to cover shifts. Two new staff have been appointed, which has made covering shifts easier. Files relating to new members of staff contain references, CRB checks, and other necessary documents are obtained before staff commence employment in the home. Formal supervision of staff has not yet been fully implemented. Staff spoken to stated that the new acting manager is proactive and supportive and will be starting formal supervision sessions in the forthcoming weeks. The deputy manager was reminded that this was a requirement made in the report from the last inspection and needs to be actioned to ensure that staff receive formal supervision at least 6 times a year. Staff meetings continue to be held and include an update on each of the service users’ needs, health and safety issues and other areas of concern which staff may wish to raise. Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 20 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): 37,39,42 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the home. The home is being appropriately managed to ensure appropriate processes and procedures are in place. However, fire safety issues need to be addressed to ensure the safety of service users in the home. EVIDENCE: By the time that the inspection had been concluded the acting manager had been appointed to the post of manager. The home has been well managed in the short time that the manager has been in charge of the home. An application to register the manager with the Commission for Social Care Inspection should be submitted. Fire safety issues regarding door closures and the adequacy of fire doors need to be addressed to ensure the safety of service users and staff. (See the Environment section of this report for details) Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 21 It is recommended that the local Fire Safety Officer should be contacted to carry out an audit in the home to ensure that service users are protected from potential harm Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 22 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 3 2 3 3 X 4 X 5 3 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 3 27 2 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 2 33 X 34 3 35 2 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 3 3 3 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 3 3 3 X 2 3 3 X X 2 X Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 23 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 YA36 Regulation 18(2) Requirement The registered person must ensure that staff receive formal supervision on at least six occasions throughout the year This was a requirement from the last inspection. Failure to comply may result in legal action being taken against the home The shower in the large bathroom in the house must be repaired or replaced and suitable screens or curtains 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 registered person must ensure that there is a training and development programme to meet the individual complex needs of the service users. The provider must ensure that care plans are written in DS0000015146.V288204.R01.S.doc Timescale for action 31/08/06 2. YA27 23(2)(j) 31/08/06 3. YA35 18 (1) (C) 31/08/06 4. YA36 15(1) (2 c, d) 31/08/06 Conquest House Version 5.2 Page 24 5. 6. YA37 YA24 8(2) 23 (2) (b) sufficient detail to ensure that care staff have clear guidance regarding the care and support needs of individual service users. An application to register a 31/08/06 manager must be made to CSCI The provider must ensure that the home is well maintained. Areas referred to in this report must be renewed, redecorated and refurbished both to the interior and exterior of the premises Staff must receive formal supervision at least six times a year 31/08/06 7. YA42 18(2) 31/08/06 8. YA42 23(4)(c)(i) The fire doors referred to in this report must be fitted with appropriate safety glass. Fire door closers must be adjusted to ensure adequate fire safety 31/08/06 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 Refer to Standard YA42 Good Practice Recommendations It is recommended that the local Fire Safety Officer should be contacted to carry out an audit in the home to ensure that service users are protected from potential harm Conquest House DS0000015146.V288204.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office 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 DS0000015146.V288204.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. 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!