Inspection on 05/12/06 for Conquest House

This inspection was carried out on 5th December 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Conquest House 25/04/06

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 Dragan Cvejic Key Unannounced Inspection 5th December 2006 10:00 Conquest House DS0000015146.V324773.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.V324773.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.V324773.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 ***Post Vacant*** 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.V324773.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. MD only in association with LD Date of last inspection 25th April 2006 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 farm house 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, or changing the purpose. A maintenance person is also employed, while the cooking is overseen by one of the senior carers. The home is owned Craegmoor Group Ltd; Conquest Care Homes (Peterborough) Limited is a subsidiary of the organisation, and continues as the registered provider. The fee was in the range of £1082 to £1625 per person. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that included a site visit that lasted 6 hours. The main methodology used was case tracking, whereby 3 service users were case tracked. Their files were read, rooms checked, the communal areas and free movement through the home was seen and they were spoken to about their experiences of living in the home. The staff, their key-workers were asked to comment on users and how their needs were met. The manager stated the results that had arisen from the actions the home carried out on requirements from the previous inspection. A tour through the building and through the garden also provided evidence for this report. What the service does well: What has improved since the last inspection? The home had responded to requirements from the previous inspection. Service users were encouraged to express their personalities and individuality. Staff and service users were encouraged to give their suggestions for improvements. The manager addressed each individual item identified for improvement and 17 requirements related to the environment were already completed. For example: a new shower was installed; new dining room furniture made the room used by many users look more attractive and reduced the number of incidents; new risk assessments recorded the actions to minimise risks, while giving more freedom to users to use their initiative. A user was allowed to go cycling unsupervised. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 6 An interpreter was called in at least once a week for the Portuguese service user. The happier, more open and friendlier atmosphere made both service users and staff happier. 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. The summary of this inspection report can be made available in other formats on request. Conquest House DS0000015146.V324773.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.V324773.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 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The information about the home was made very accessible to potential and existing users. The home carried out an effective and comprehensive assessment prior to a offering place to potential users to ensure that they could make a clear and informed choice and, once admitted, their needs were met. The home exceeded minimum standard requirements. EVIDENCE: The information about the home was updated when the new manager was appointed. Produced in an appropriate format and explained verbally to users and their families became the standard of presenting the home. The newly admitted service user’s file was inspected and showed details of the admission procedure. It contained the previous care plan from a different local authority that was very detailed. The home’s assessment of the user expanded basic needs and addressed in addition cultural differences, a few Portuguese words and phrases and a booklet “Language and culture special information guide”. The guide pointed out to potential issues: “physical contact may be an issue”. The other two files of case tracked service users contained similar, detailed information of the initial assessments. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 9 All three files contained records in care plans and record sheets demonstrating that users’ needs were met. One of case tracked users commented: “I get all I want here. Conquest House DS0000015146.V324773.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): 6,7,8,9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users were in control of their lives through involvement in care plans, risk assessments and participation in running the home. EVIDENCE: Three service users were case tracked and their files were checked as a part of the inspection process. Care plans were improved since the previous inspection and with added details were much clearer and more descriptive. They were written in the first person and indicated users’ involvement. A new, piloting care planning for the organisation was carried out in this home. Person centred planning approach was prepared to go live on the electronic system before Christmas. Service users’ personal comments were the basis for care plans. Apart from regular reviews, the areas that changed more often than the reviews timescale, were reviewed at the time of the change. An example was of the seating arrangement in the minibus that was reviewed monthly. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 11 Restrictions and limits were recorded in care plans. A “Language and culture Guide” was included in the care plan for a service user from a Portuguese background. Risk assessments were completely revised and very well recorded. Staff were trained to use the signing in simplified Makaton, to communicate effectively with three non-verbal service users. A service user came to the office during the site visit, feeling comfortable and “at home” in the manager’s office. He explained how he took part in decorating his room. He also commented that he was asked about his opinion if a referred user would fit into the home. His independence and risk taking were confirmed in his file and he confirmed that he goes out for cycling alone, which he enjoyed. Social workers were involved in risk assessment for all three case tracked users. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service users were able to control their lives and were supported to exercise choice, independence, their rights, and to explore reasonable risks. EVIDENCE: The majority of service users had a structured weekly programme that was set during care planning meetings with them. Several users attended college. A case tracked user had started swimming in a local pool during general swimming. He stated that he went to the pub. Sometimes with staff, sometimes without, on his own. A risk assessment for him going swimming on his own was recorded. A service user loved cycling and was allowed to go out on his own for cycle rides. This was recorded and managed through risk assessment. An interpreter was engaged to visit service users once a week and called for all reviews. Another service user from a Caribbean background attended the Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 13 Millennium Centre where there was an opportunity to taste different, exotic food. All service users spoken to were happy with the food and choice of food. Some liked cooking and cooked with staff support. Mealtimes were organised with flexibility and users could choose where and when to eat. The cook knew users’ likes and dislikes well. New dining room furniture significantly improved conditions for service users to eat together in the dining room. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home respected service users wishes, privacy and dignity when their healthcare was dealt with. Service users were protected with clear and safe healthcare and medication procedures and practices. EVIDENCE: New Clinical Governance auditing system was introduced and with a new users’ assessment form, helped closer monitoring of users’ health conditions. Care plans clearly instructed staff how the personal care should be offered to service users. Daily records were compared for 3 case tracked users with their care plans and recorded staff input matched actions from care plans. Staff commented that care plans were now written much better and were used to guide them in offering care. In addition they knew service users well. A mixture of male and female staff to reflect service users’ gender enabled respect for users choice when they wanted male of female staff to help them. Daily routine was agreed with each individual. When a case tracked service user was not happy with another user playing music during a particular time, Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 15 he was advised to talk to another user and to discuss timing for both of them for when to play music without disturbing the others. The home developed a sensory room that provided further comfort to service users. There were a number of external specialist professionals involved in care: a speech therapist, epilepsy nurse, diabetic nurse and community psychiatric nurses. Service users knew their key-workers and two of three case tracked stated that they get on “very well indeed” with their key workers. Users’ files demonstrated very good standards of healthcare, visits by external professionals and the home’s actions to ensure regular visits by relevant health workers that were regular. Also the home initiated reviews of medication with the GP when the staff noticed a potential benefit to a service user in a change of medication. Medication process and records were accurate, safe and protected service users. The reported incident regarding medication was thoroughly investigated and further measures were introduced to minimise future potential risks. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 22,23 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home valued highly the safety of service users and a number of procedures and policies were in place to ensure users’ protection. The home exceeded minimum standards in this area. EVIDENCE: The home had an effective and clear complaints procedure. It was developed in picture format and was given to all service users. It stated the time scale for responding, investigating and reporting back to a complainant. The record of a complaint investigated by the company showed respect of their timescale. The outcome of referring the previous manager to the Protection of adults register showed the determination of the home to protect service users. The head office of the company was now more involved in investigations, helping the home to become more objective and effective. A new accident/incident monitoring system was established. The process and procedure exceeded the standards. Protection of users was approached very sensibly. Some risks were allowed, to promote users’ independence, but without compromising their protection. Social workers were involved in all protection issues to ensure objective, but effective measures were in place for users’ protection. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 24,26,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The improvements already made in the home were appreciated by service users and plans for further improvements were clear and demonstrated the home’s intention to provide an excellent environment that service users could enjoy. EVIDENCE: During the previous inspection 32 recommendations were made related to the environment. By the time of this site visit, 17 items were completed and the rest were addressed, ordered and approved by the company. The home’s environment was significantly improved and made more comfortable and appropriate for service users’ conditions. The shower was replaced, screening in the shower was ordered. Fire doors were made safe and secure, were inspected by the fire officer and approved. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 18 New sofas and armchairs significantly increased seating space. The new dining room enabled more service users to be present in at the same time, but at the same time, due to a good design, reduced breakages and incidents by 50 . A sensory room was used according to plan, for 3 service users, but was also open to the rest of them if they wanted. A user keen on gardening had got a vegetable patch in the garden. The kitchen was inspected and was clean and tidy, promoting infection control measures. New curtains made the home look warmer and nicer. The walls were decorated by users’ handmade textile pictures. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35,36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The staff team was skilled, experienced and able to meet the service users, needs. Service users were protected by procedures that ensured proper vetting of new staff and training appropriate to their roles and service users’ needs. EVIDENCE: The skills and the style of the new manager affected significant progress of the home in relation to outcomes for service users. Staff were clear of their roles. A staff member commented that staffing motivation and morale were much better now. “We are always listened to. Practical ideas were encouraged.” The recruitment process was respected and inspected files contained evidence of vetting staff. New Criminal record disclosures were applied for for longer serving staff. The main values of the home were clearly communicated to staff. Staff were well organised. The overtime was reduced but the effectiveness of work was increased. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 20 New training records and stats monitoring by the M; New training included: Epilepsy, Diabetes, Challenging Behaviour, Autism, Communication; New records were excellent! 3 month inductions were very good and included initial training in mandatory subjects. Staff were supervised every 6 weeks. Conquest House DS0000015146.V324773.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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,41,42 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home promoted and encouraged safe working practices and listened to staff and service users to identify all potential hazards and minimise them. Service users were protected, but still allowed to exercise autonomy, individuality and creativity. EVIDENCE: The new stable and able manager with people and management skills, determined to support service users and staff was in the post. She created an atmosphere where staff felt respected, supported, valued and were encouraged to express their positive ideas and innovation skills. As a result, a new weekly communication leaflet was introduced. Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 22 The manager organised a system whereby each area was audited on a 2monthly basis, as required by the company’s policy introduced by the Clinical Governance Team at the Worcester Support Centre. The company’s divisional office organised a survey as a part of quality assurance review and analysed data were sent back to the manager to feed back to participants. The manager displayed the results in a communal area of the home, making them available to all. The manager explained that new lines of communication were created by the organisation, allowing staff or users to contact a director if necessary. Records kept in the home were either updated or in the process of being updated as instructed by the manager. Training was in particular well organised, recorded and expanded to ensure staff were trained in relevant and purposeful subjects. New records for accidents/incidents allowed proper analysis and planning to reduce hazards. The home exceeded standards in many management areas. Conquest House DS0000015146.V324773.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 4 2 4 3 3 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 X 26 3 27 X 28 3 29 3 30 3 STAFFING Standard No Score 31 4 32 3 33 4 34 4 35 4 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 4 3 4 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 4 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 4 4 3 X 4 4 4 X 4 3 X Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Conquest House DS0000015146.V324773.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB21 5XE National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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.V324773.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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