Inspection on 20/10/05 for Curlews

This inspection was carried out on 20th October 2005.

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 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

Curlews 24/11/06

Curlews 05/01/06

Curlews 10/02/05

Curlews 22/06/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Curlews Dunsland Jacobstowe Okehampton Devon EX20 3RH Lead Inspector Antonia Reynolds Announced Inspection 20th October 2005 12:15 Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Curlews Address Dunsland Jacobstowe Okehampton Devon EX20 3RH 01837 810856 01837 810819 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) Atlas Project Team Limited Mr Michael James Brummitt Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Service Users with a Learning Disability (4) Age 18 - 65 years Date of last inspection 10th February 2005 Brief Description of the Service: Curlews is a care home providing personal care and accommodation for four people, aged 18 – 65, with learning disabilities who may demonstrate behaviours that challenge services. It is owned by the Atlas Project Team Limited, which is a private sector organisation, owning several other care homes in Devon, Berkshire and Surrey. This home is located in a rural setting, and there are no close neighbours. The home provides transport for service users to access shops, pubs, and other amenities. The home was opened in 2002 and is comprised of a two-storey detached house. All the home’s bedrooms are single and two of these have en suite toilet and shower facilities. There are separate lounge and dining rooms, as well as a large sunroom on the ground floor. Part of the lounge room has been designated as a smoking area. The home has a very large garden, with parking facilities and a paddock at the back of the house. All areas are accessible to the service users. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This announced inspection took place between 12.15pm 2.50pm. The Registered Manager, Mike Brummitt, and the home Manager, James Butcher, were present throughout the inspection. A tour of the premises took place and records relating to care, the staff and the home were inspected. All four of the service users, as well as staff on duty, were spoken with and observed during the visit. Comments were received from the four service users as well as two relatives, all of which expressed satisfaction with the care provided. What the service does well: What has improved since the last inspection? What they could do better: No issues were identified at this inspection. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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, 3, 4 and 5 The home’s Statement of Purpose and Service User Guide provide service users and prospective service users with details of the services the home provides, enabling an informed decision about admission to the home. EVIDENCE: No new service users have been admitted to the home since the last inspection. However, the organisation has a detailed admissions procedure where all prospective service users are assessed prior to admission by the senior management team within the organisation and have plenty of opportunities to visit. Individual records are kept for each of the service users and these contained detailed assessments, care plans and risk assessments. Discussion with the management team confirmed that specialised services were accessed if necessary. Contracts with purchasing authorities are kept in the organisation’s head office, but statements of terms and conditions are available for each service user. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 and 9 Service users are enabled to participate in, and make decisions about, all aspects of their lives. EVIDENCE: Each service user has an individual plan of care, as well as procedures relating to behavioural needs, and these plans are reviewed regularly. Any restrictions on choice or freedom are documented and agreed with the service user and other people involved in the person’s care. Detailed risk assessments are carried out relating to various aspects of the service users’ lives to ensure that they are able to participate in anything they choose to do, with the least risk. Where a monitoring device is used, it is positioned so that it only affects the individual service user concerned, the service user is aware of it, and the staff have guidelines to follow. Discussion with service users and the management team, as well as observation, showed that service users participate in all aspects of life in the home, although the level of involvement depends on individual abilities and willingness. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 10 The Manager confirmed that each service user has their own bank/building society account and records relating to the administration of money were satisfactory. Service users are expected to pay for personal items and make a contribution to the weekly takeaway meal. Other costs, such as transport and holidays, are met by the organisation. The home has a system whereby service users have an opportunity to earn additional money. One of the service users confirmed that staff are working with him to improve his financial management skills. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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): 11, 12, 13, 14, 15, 16 and 17 Service users can learn life skills, attend college, participate in any community and leisure activities, choose their own daily routines and enjoy a healthy diet of their choice. EVIDENCE: Discussions with service users and the management team showed that people are enabled to attend various courses of their choice at local further education colleges. Service users are able to go shopping or take part in various leisure activities of their choice when they choose to, unless the risk assessment indicates otherwise. It was evident, through observation during the inspection, that service users consider this to be their home and are empowered to make decisions, in negotiation with the staff team. One of the methods of encouragement used is a development incentive programme where service users are paid for tasks achieved. Service users and the management team confirmed that holidays abroad and in the United Kingdom were arranged for all the service users this year, although they were not all able to go because of particular personal issues that arose. The organisation presently funds all holidays for the service users. The Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 12 home provides a seven-seater people carrier and a car for use by the service users. Staff are not expected to use their own car to transport service users. The service users are encouraged and facilitated to keep in touch with, and see, family and friends, and the home ensures this happens by providing staff support and transport, at no cost to the service users or their families. Service users have a choice of meals, help to choose the menu, alternatives and snacks are always available and records are kept of meals provided. Privacy is respected and bathroom doors are fitted with suitable locks. Bedroom doors have locks that are lockable from both sides with a key, however none of the service users have keys and the reasons for this are documented. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 and 20 Service users can be confident that personal support is provided in the way, and at the time, that they want and need. Health care needs are addressed as soon as they are identified. EVIDENCE: Service user plans provide information about personal and health care needs. Through observation it is clear that timings are flexible and the choice of the service user. Discussion with the management team confirmed that external professional advice and guidance is sought when necessary from local health care professionals or social services. Visits to and from health care professionals take place in private although staff are always present to facilitate communication and because of the needs of the service users. Individual risk assessments are carried out regarding whether or not service users are able to keep their own medication, the result being that no-one selfadministers medication. The organisation has its own system for the administration of medication which they have tried and tested over many years, and believe that it is the most appropriate system for them. Medication is locked away safely and records pertaining to its administration are clear, well kept and accurate. Medication prescribed to be taken ‘as required’ is only administered by staff following consultation with a senior manager. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 and 23 Service users are protected from abuse, neglect and self-harm. Service users can be confident that complaints are always dealt with seriously and any concerns from service users will be listened to and acted upon immediately EVIDENCE: Neither the home nor the Commission for Social Care Inspection have received any complaints since the last inspection. Service users confirmed that they knew what to do/who to speak to should a problem arise. The home has a complaints procedure and staff and management always respond immediately to any issues raised by service users or their relatives. Regular house meetings are held where any issues or concerns can be raised and dealt with immediately, although service users can raise any issue at any time. The management team are aware of adult protection issues and procedures and training has been undertaken, or is planned, for all staff members. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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, 25, 26, 27, 28, 29 and 30 The standard of the environment is very good, providing service users with an attractive and homely place to live. EVIDENCE: The home is large, comfortable, safe, clean and well maintained. The home’s lounge and dining rooms are comfortably furnished and there is also a sun room available for people to use. Decoration is ongoing and all the rooms are decorated to a good standard. The home is in a rural setting and two vehicles are provided to enable service users to access local amenities with staff support. It was evident that service users feel ‘at home’ in the environment and each service user has a large, single bedroom on the 1st floor, which are decorated individually and contain personal possessions. Two of the bedrooms have en suite showers, toilets and wash hand basins. The other two bedrooms do not have wash hand basins due to the needs of the service users. On initial registration the use of the smaller two rooms was agreed on the basis that the occupants would have the sole use of a 5th room, for whatever purpose they chose, however they have never used this room as they prefer to use the main communal rooms. In addition to the en suite facilities the home has a Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 16 bathroom with a toilet and wash hand basin on the 1st floor and two separate toilets on the ground floor, all of which are fitted with appropriate locks. The service users said that they participated in keeping the house clean and in the upkeep of the garden, but confirmed this was their choice. Responsibilities for housekeeping tasks are agreed with the service users and written up in their personal programmes. The home had portable telephones for service users to have private conversations. The home had an office where staff could store belongings when on duty as well as a sleeping in room with a shower and wash hand basin. Part of the room used for staff sleeping in has been arranged as a private area for one of the service users. Kitchen and laundry facilities are satisfactory and service users are encouraged to do as much as possible for themselves. The home does not have a call alarm system or any specific aids and adaptations, apart from hand rails, as these are not required for the service users. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 34, 35 and 36 Recruitment procedures are robust and service users’ needs are met by high staffing levels. Service users benefit from well-supported and supervised staff, creating a calm, relaxed and pleasant atmosphere in the home. EVIDENCE: Staff files inspected show that the organisation has a robust recruitment procedure and all the required information is available. Criminal Record Bureau checks are carried out and are kept in the organisation’s head office. Confirmation that they are carried out is evident in staff files and more recent checks were available for inspection. Regular staff meetings take place, which service users can also attend. The Manager confirmed that regular individual supervision sessions take place with staff members. The organisation has a training officer who maintains an overview of what the organisation requires, as well as ensuring that individual staff members receive the training they need. Training records sent to the Commission for Social Care Inspection confirmed that staff were enrolled on various courses including National Vocational Qualifications and were expected to participate in training as required by the organisation, for which they were paid. Training included induction, emergency first aid, health and safety, food hygiene and adult protection as well as training specifically related to the service users, such as Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 18 behavioural management courses and strategies for crisis intervention including defusion/distraction techniques as well as physical restraint. The Manager confirmed that the staffing numbers are usually three from 8am to 9am, four staff from 9am to 9pm, three from 9pm to 10pm and one waking and one sleeping in night staff. However there are occasions when the staffing between 8am and 10pm may reduce by one. The care staff carry out the domestic and household tasks, whilst working with service users to be as independent as possible. The organisation operates an ‘on call’ system whereby members of the management team are available both in and out of office hours. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 19 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, 38, 39, 40, 41 and 42 The management approach of the home is open and positive and provides clear leadership, with the management team believing in leading by example. Service users’ rights, health, safety and welfare are protected and promoted. EVIDENCE: The Registered Manager has completed a level 4 National Vocational Qualification and the Registered Manager’s Award, and has commenced a Bachelor of Science degree in Intellectual Development and Disability. The home also appointed a Manager who is following the organisation’s trainee management scheme and is in the process of completing the level 4 National Vocational Qualification in Care and the Registered Manager’s Award. Lines of accountability are clear and the organisation has a management structure that enables it to cover absences when required, and provide an effective ‘on call’ system to support staff. The Manager confirmed that staff are consulted and included in any decisions regarding the running of the home. Service users confirmed that their views are listened to and that any decisions about the management of the home take these views into account. The Manager carries out an internal quality monitoring audit every six months. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 20 All documentation relating to service users is detailed, up to date and accurate. Records relating to health and safety issues, such as risk assessments, the accident book, fire log book, and employers liability insurance certificate are available and up to date. The Manager confirmed that all staff are up to date with fire safety training and the fire doors have recently been replaced. Monthly provider visit reports are being carried out and copies of the reports sent to the Commission for Social Care Inspection. The Manager confirmed that all staff complete training in emergency first aid, health and safety, food hygiene and fire safety. Infection control practices were satisfactory. The Manager confirmed that a valve to control the temperature of hot water is fitted to the bath and risk assessments have been carried out relating to service users and hot water/surfaces. Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 21 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 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 4 3 3 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 3 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score 3 3 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Curlews Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 3 3 3 3 X DS0000032251.V259644.R01.S.doc Version 5.0 Page 22 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. 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 Curlews DS0000032251.V259644.R01.S.doc Version 5.0 Page 23 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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