CARE HOME ADULTS 18-65
Emscote House Emscote Drive Wylde Green Sutton Coldfield West Midlands B73 5NE Lead Inspector
Gerard Hammond Unannounced Inspection 21st March 2006 14:35 Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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 Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Emscote House Address Emscote Drive Wylde Green Sutton Coldfield West Midlands B73 5NE 0121 382 1463 0121 382 1463 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) Norman Laud Association Mrs Lesley Pamela Somerfield Care Home 8 Category(ies) of Learning disability (8), Physical disability (8) registration, with number of places Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Residents must be aged under 65 years Ms Somerfield completes the Registered Managers Award and NVQ 4 in care within 18 months of the date on this registration certificate. 13th October 2005 Date of last inspection Brief Description of the Service: Emscote House is registered to provide accommodation, care and support for up to eight people with learning disabilities, who may also have additional physical disabilities. This is a respite care service, aimed generally at serving the needs of younger adults. The property was purpose built: all respite accommodation is provided on the ground floor of the building, in single bedrooms. Rooms are designed to meet a varied range of support needs. The Home has well equipped standard and specialist (assisted) bathrooms, offering bathing and shower facilities. The kitchen links two roomy dining areas: both these rooms also double as areas for tabletop activities. There are also two well-furnished lounges that include televisions, video / DVD, stereo, and computer games console. The newly built conservatory also offers additional space for games, snooker table, parties and so on. There is an extensive private and enclosed garden to the rear of the property. At the front are shrub borders and parking spaces. The Home is situated at the end of a cul-de-sac in the residential area of Wylde Green. Local amenities include shops, library, medical centre, places of worship and a range of leisure and recreational facilities. The area is well served by public transport, including rail and bus routes. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second inspection visit in the current year, and was unannounced. This report should be read in conjunction with the one written following the inspection completed on 13 October 2005. Sample checking of records (including personal files, care plans, previous inspection reports and safety records) were used for the purposes of compiling this report. The Inspector was able to meet with the seven people in residence. Their learning disabilities and communication support needs meant that, in general, it was not possible to seek their views directly. The Deputy Manager on duty was formally interviewed and three other members of staff seen informally. A tour of the building was also completed. Throughout this report, people using the service are referred to as “guests”, which is the preferred title. What the service does well:
As reported at the time of the last inspection, this respite care service has a thorough admissions procedure and provides opportunities for people to visit before making a decision about whether or not to stay. Careful consideration is given to making groups of people staying at any given time as compatible as possible. Guests enjoy access to a good range of activities, both out in the community and also in-house. The approach to what people do is flexible: if guests want to continue to access their usual day activity programme then this is facilitated, but alternative arrangements can be made if people do not have formally structured programmes. They have access to a balanced, nutritious diet, and mealtimes are relaxed and sociable occasions. People staying at Emscote House enjoy an excellent, purpose-built environment that is homely and comfortable, and equipped and fitted to a very high standard. The Home is able to cater for people with a wide range of support needs. Personal care is given respectfully and to a good standard. The management approach is open and inclusive, and displays a positive attitude towards developing the service for the benefit of the people who use it. There is a transparent complaints culture in the service that encourages people to let their concerns be known, and seeks to address them appropriately. There is a strong commitment to recruiting, training and developing the staff team appropriately. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 6 What has improved since the last inspection? 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.
Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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 Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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): 2, 3, 4 Prospective users of this service have their needs and aspirations assessed appropriately. They have opportunities to visit, and are able to satisfy themselves that their support needs and wishes can be met by the home, prior to choosing whether or not to use the service. EVIDENCE: Key Standard 2 and Standard 4 were assessed at the last inspection and fully met. The personal files of 3 guests in residence were sample checked. Appropriate assessments were in place. The service has a thorough admissions procedure, and this includes opportunities to visit and try out what is “on offer” before making any decisions about using it. The home is very well equipped, and people visiting are able to see clearly the range of needs that can be catered for, and obtain any other information they might want from the staff team. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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 Care plans are developed to reflect individuals’ assessed and changing needs, their preferences, and their personal goals. EVIDENCE: Key Standards 6, 7 and 9 were assessed at the last inspection. Standards 7 and 9 were fully met. A requirement was made at that time that care plans should be developed to include more detail about how support should be given, and to reflect individuals’ personal goals. Since then a new assessment and care plan format has been devised and is being introduced as plans are reviewed. It has to be acknowledged that the numbers of people using this service means that this is a significant undertaking. As plans are developed, attention should be paid to ensuring that guidance about how support should be given is specific and appropriately detailed. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 10 In the last inspection report it was recommended that person-centred approaches were introduced, in keeping with the aspirations of the Government White Paper “Valuing People”. It should be acknowledged that some work has already gone on in this area, and continues to be developed further. This should be particularly useful in gaining information about people’s preferences, and agreeing personal goals. Current care plans are driven by the requirements of providing the service in that particular environment. Because Emscote House is a respite care service, and people only stay there for short periods, these are not, by definition, “whole life” plans. However, staff are now taking positive action to gain information from other sources (such as day centres) to see if there are ways that the service can better support individuals to achieve their personal goals. This is a good example of the willingness of the care team to be creative and constantly to seek ways to develop the service for the benefit of the people using it. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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, 14, 16, 17 People using the service are part of the local community, and can take part in appropriate activities of their choosing. Staff respect people’s rights to make choices and encourage them to do what they are able for themselves. People enjoy a healthy and balanced diet and mealtimes. EVIDENCE: Key Standards were all assessed at the last inspection and fully met. Sample checking of guest’s personal records provided evidence that they continue to be supported to access regular daytime activities at school, college and day centres where appropriate. People also access local amenities with support as required, and this includes shops, pubs, clubs, restaurants and other community facilities. As previously reported, guests also have access to a good range of equipment and facilities for entertainment in the home, should they wish.
Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 12 The Inspector was able to observe directly the guests in residence taking their evening meal. People were able to exercise choice about what they had, and have their meals when they wanted them. The atmosphere was relaxed and sociable. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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 People receive preferences. EVIDENCE: Key Standards 18, 19 and 20 were assessed at the last inspection, and met in full. Staff were directly observed supporting guests. Support was given in a warm and friendly manner and was appropriately respectful. Guests and staff appear to enjoy a good general rapport, and to be relaxed and at ease in each other’s company. Individuals’ attire and personal grooming provided evidence that basic personal care is given to a good standard. People are encouraged to be as independent as their personal abilities allow. support in accordance with their assessed needs and Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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): EVIDENCE: Key Standards 22 and 23 were assessed at the last inspection, and fully met. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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, 27, 28, 29, 30 Emscote House is safe, comfortable and homely. Guest’s rooms, and the home’s bathrooms and toilets, suit their individual needs, privacy and lifestyles. Shared spaces environment. complement individual rooms and enhance the living Guests have access to necessary specialist equipment to promote their personal independence. The house is clean and tidy, and a good standard of hygiene maintained. EVIDENCE: A tour of the premises was completed. As previously recorded, Emscote House provides a warm, welcoming and homely living environment for people using the service. The house is purpose built and can cater for people with a wide range of support needs, including significant physical disabilities.
Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 16 It is wheelchair accessible throughout. Bedrooms are comfortable and much thought has been given to individual design, flexibility and adaptability according to people’s requirements. Bathing, washing and toilet facilities can cater for people requiring full assistance, and the home is well equipped with specialist equipment including mobile hoists for lifting and handling (with a range of different slings) and grab rails. Shared spaces are more than ample and include two dining areas (that also get used for other activities), two lounges and a conservatory. All these overlook an extensive rear garden, which provides an attractive outdoor space for guests to use when the weather permits. The house is well maintained, kept clean, tidy and hygienic. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 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): 32 People using the service benefit from being supported by a well qualified, competent staff team. EVIDENCE: Key Standards 34 and 35, and Standard 36, were all assessed at the last inspection and met in full. This service has a demonstrably high commitment to training. Five of the current care team (excluding senior staff) are qualified to NVQ level 3, with another two members of staff working towards this. Two other staff are qualified to NVQ level 2. The training plan shows that further courses in adult protection, makaton and epilepsy are already scheduled. The whole staff team received training in person-centred planning in February 2006. Refresher training in fire safety is to be scheduled shortly. Documentary evidence demonstrates that training is well planned and organised. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: Key Standards 37, 39 and 42, and Standard 38 were all assessed at the last inspection. A requirement was made at that time that the Organisation should develop its Quality Assurance and Monitoring Systems, so that results could be analysed and shared with all parties concerned. This was not assessed on this occasion, and is shown as outstanding in this report for that reason. It should be acknowledged that there is a good deal of evidence that the Organisation actively seeks the views of people who use the service, and their families. The aim of the requirement is to encourage the Organisation to think how this positive action might be taken forward. National Minimum Standard 39.3 proposes that continuous self-monitoring should use an objective, consistently obtained and reviewed and verifiable method, which should preferably be a professionally recognised quality assurance system. Standard 39.4 says that results of service user surveys are published and made available to service users, their representatives and other interested parties.
Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 X 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 X 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 3 15 X 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 X X X X X X X X X X Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA39 Regulation 24 (1-3) Requirement Develop Quality Assurance and monitoring systems for the service, so that results may be analysed and shared with all parties concerned. Timescale for action 30/06/06 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 YA6 Good Practice Recommendations Develop clear communication guidelines for people with communication support needs and place them prominently on individual care plans. Seek to further develop person centred approaches, in keeping with Valuing People. Emscote House DS0000016726.V287561.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection Birmingham Office 1st Floor Ladywood House 45-46 Stephenson Street Birmingham B2 4UZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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