Inspection on 07/04/05 for Estoril

This inspection was carried out on 7th April 2005.

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

The inspector 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

Estoril 24/04/07

Similar services:

Coopers Mill Ltd

Bramley Avenue (73)

Paradise Lodge

Grangewood

Upaya Ananda

Newton Court (1-2)

Kings Lane (32)

Pemdale

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

CARE HOME ADULTS 18-65 Willow House Wonston Road Southminster Essex CM0 7FE Lead Inspector Jenny Elliott Final Unannounced 07 - 25 April 2005 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationary Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Willow House Version 1.10 Page 3 SERVICE INFORMATION Name of service Willow House Address Wonston Road, Southminster, Essex CMO 7FE Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01621 774776 gary.leckiezerothreecarehomes.co.uk Zero Three Care Homes LLP Gary Leckie Care Home 5 Category(ies) of PC Care Home 5 Learning Disability registration, with number of places Willow House Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: Persons of either sex, under the age of 65 years, who require care by reason of a learning disability (not to exceed 5 persons). Date of last inspection N/A Brief Description of the Service: Willow House care home was first registered in January 2005. It is a family sized house in Southminster. The home can accommodate up to five people with a learning disability, but is not suitable for people with a physical disability. Four bedrooms are on the first floor and one bedroom is on the ground floor. The house is well decorated and furnished. There is a conservatory to the rear of the building and well maintained gardens. The house is close to local shops, health services and the train station. The home provides twenty four hour support and can accommodate men or women aged 18 to 65. Staff can support people living at the home to use community, leisure, health and educaiton facilities as well as provide personal care. The home helps to develop the independence skills of people living at Willow House and involves people in day to day decisions about the home as well as their individual futures. Willow House Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Thirty one standards were covered at the inspection, three standards were identified as having minor shortfalls, 26 as meeting minimum requirements and one as exceeding minimum requirements. This inspection was carried out through a site visit on 7th April and subsequent review of documentation and contact with placing officers. The inspector arrived without prior warning and spent about 4 hours at Willow House. During that time two people living at the home and three staff working at the home were spoken with. In addition time was spent observing the behaviour of people living and working at the home and looking at some of the records kept by the home. Time was also spent outside of the visit reading documents, reports and other information provided by the home and contacting placing social workers, as a result the inspection did not finish until the 25th April 2005. This home opened in January 2005, this was the first inspection of the home. What the service does well: The home was clean, well decorated and furnished and had a ‘homely’ feel. The relationship between staff and people living at the home was relaxed but professional. Staff were observed spending time talking to people living at the home, assisting people to make choices about food and trips out. People living at the home were encouraged to undertake tasks such as making tea for visitors, answering the phone and talking to visitors. Day to day consultation with individuals was good. Throughout the time spent at the home people living Willow House were moving around the house and garden, some went for a ride in the mini-bus, one person went to the shops another for a walk and another to have their hair cut, each person was appropriately supported. One of the people living at the home told me they preferred Willow House to their last place because ‘no one tells you when to get up or change your bed.’ The home was flexible, giving people living there choices about how to spend their time and what trips, outings and other activities they wanted to take part in. People coming to live at the home had been introduced slowly, with visits followed by overnight stays, helping to ensure a smooth transition from one Willow House Version 1.10 Page 6 home to another. The manager of the home spoke to parents, current carers and social workers to gather as much information as possible about people coming to live at the home, so that their likes, dislikes and methods of communication could be better understood. Review meetings were set up within one month of people moving in to make sure they were settled and receiving the support they needed. The home had been open for less than four months at the time of this inspection. The overall impression of the home at this stage is that it provides a good quality of care. 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 full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Willow House Version 1.10 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Standards Statutory Requirements Identified During the Inspection Willow House Version 1.10 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users’ know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) .1,2 3 & 4. The home operates a comprehensive assessment programme that provides opportunities for prospective service users to influence the service offered in line with their needs. EVIDENCE: The home’s Statement of Purpose and Service User Guide provide a good level of information about the services provided. The home opened very recently and was implementing for the first time many aspects of its Statement of Purpose. The Statement of Purpose should be reviewed to ensure that it is amended where practice develops differently to that stated. The manager advised that the Service User Guide was also available in DVD format. The home completes its own comprehensive assessments, drawing from a range of sources in addition to the information provided by placing officers. Assessments made a direct link between support requirements and staffing hours ensuring appropriate funding and staffing levels. Records sampled indicated that prospective service users had made visits to the home including overnight stays. One social worker described a ‘fantastic transition’ praising in particular the joint working between Willow House and the service users previous home. Willow House Version 1.10 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 standard(s) 6,7,8 & 9. People living at the home were given opportunities to make decisions about their lives and to participate in the daily life of the home. EVIDENCE: Behaviour action plans, preferred routines and risk management plans were completed in the records sampled. These documents inter-related where relevant and provided clear information for support staff. Service users personal goals and weekly activities were not recorded. The home had been flexible in its approach to working with people who have a range of needs and levels of communication. Discussion with people living at the home and observation during the inspection demonstrated that people were given choices about meals, activities and trips out. People living at the home took part in the daily tasks of running the home. People living at the home behaved in a manner that suggested they had real ownership of the home. A meeting of all the people living at the home had not been held. The inspector was advised that it had been decided to hold these monthly and that the Statement of Purpose and Service User Guide would be amended to reflect this. Willow House Version 1.10 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 11,12,13 &14 People living at the home were given opportunities to participate in a range of appropriate activities inside and outside the home. EVIDENCE: During the inspection staff were observed talking to people living at the home about a trip out in the mini-bus, a trip to the local shops and a trip to the hairdressers. One of the people living at the home was completing a jigsaw puzzle with staff, this was an activity identified in their care plan. One of the people living at the home was observed helping with the distribution of post, making hot drinks and answering the telephone. This person also provided the inspector with a guided tour of the premises. Two people living at the home told the inspector about walks and trips in the countryside and to local towns, trips to the pub and shops and leisure centres in the area. One of the people living at the home was helping out at a local café and was interested in attending college in the future. Willow House Version 1.10 Page 11 Care plans did not include a weekly timetable of events so it was not possible to quantify the amount of time spent on planned activities. People living at the home had a range of communication, comprehension and social skills likely to require a wide range of suitable activities and different levels of staff support. Assessments of needs reflected staffing levels required by individuals and the staff rota demonstrated that staffing levels were consistent throughout the waking day including weekends. Willow House Version 1.10 Page 12 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 & 20 The physical and emotional health needs of people living at the home were fully assessed and generally well met, ensuring timely and appropriate responses to poor health. EVIDENCE: Two sets of records belonging to people living at the home were inspected. These held comprehensive information about health difficulties experienced by the individuals concerned. Half of the staff team had received training relating to epilepsy and plans were in place for the remaining staff to attend a similar session. Clear plans were in place for staff to respond appropriately to seizures experienced by one person living at the home and records indicated that these had been followed. Appropriate and timely referrals had been made to specialist services including occupational therapists and speech and language therapists. Neither of the files inspected had details of dentists entered. The manager advised that a dentist had been identified. None of the people living at the home administered their own medication. Medication and records relating to its administration were held securely within the home. Each medication administration record (MAR) sheet had a photograph of the person to whom it related attached, minimising the risk of Willow House Version 1.10 Page 13 misadministration. The MAR sheets were shaded at the times and days medication was due, the shaded boxes were too dark to clearly read the signatures of staff administering. Information was held about the drugs in use. Willow House Version 1.10 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 standard(s) 22&23 The risk of harm or abuse was minimised for people living at the home. EVIDENCE: The home has a clear protection policy, training and supervision for staff, regular visits by a consultant experienced in working with people with a learning disability and visits from placing social workers, all of which contribute to minimising risks of harm or abuse to people living at the home. Although a house meeting, involving everyone living at the home had not been held, the consultative nature of discussion observed during the inspection and described by people living and working at the home, demonstrated that views were listened to. One of the people living at the home had a contract for living at the home that listed agreed behaviours identified to protect that person. Daily meetings were held to review adherence to the contract. A reward programme had been developed to support compliance with the contract. The person subject to this contract had a clear understanding of what was required of them. The behavioural action plan for one of the people living at the home included the statement ‘If staff have any concerns that allegations should be taken seriously…’. This statement , and home practice, should be reviewed to ensure that care staff are not making decisions about the validity of an allegation made by anyone living at the home. Willow House Version 1.10 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 standard(s) 24,25,26,27,28,& 30 Willow House provides a safe and homely environment for the people living there. EVIDENCE: This home was registered in January 2005. At this time it met all conditions for registration. This included meeting the requirements of building regulations, fire safety and environmental health. The home has been decorated and furnished in a homely way. Facilities at the home for cooking and laundry were designed in a way to encourage people living at the home to develop their skills in these areas. At this inspection (about three months since registration) the condition of the decoration and furnishing had been maintained. The house was clean and hygienic. There was no specialist equipment required by people living at the home. The garden to the rear of the property was also well maintained providing a grass area and patio. Willow House Version 1.10 Page 16 The manager has advised the Commission that they want to increase the amount of shared space available by converting the garage adjoining the property to another room. Willow House Version 1.10 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 35 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 33,34,35 & 36 People living at the home benefit from a staff team that have the qualities, training and support required to meet their needs. EVIDENCE: The partners of Zero3 took advantage of opening a new home by working with the staff team in advance of people moving in, to build the team and provide some training and induction sessions. One member of staff thought the initial 2 weeks were ‘great, helping with team building and setting out the company’s ethics.’ The ratio of staff to people living at the home ensures that individual needs can be met, and that activities do not necessarily have to be carried out on a group basis. Staffing levels were directly related to the assessed needs of people moving into the home. One of the people living at the home said there was always someone they got on with on a shift. As indicated previously, referrals have been made to specialist services where appropriate. Staff recruitment records demonstrated that all checks had been carried out and that posts were offered subject to satisfactory completion of a probationary period. All staff were either working towards or had completed Willow House Version 1.10 Page 18 the Learning Disabilities Award Framework (LDAF) induction programme. Staff confirmed they received regular supervision. The notes held on file were not specifically related to their roles and should be developed. Willow House Version 1.10 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 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37,38,40,41 & 42 The Home is managed in a way that fulfils its stated purpose and objectives and meets the needs of people living there. EVIDENCE: The registered manager of the home has significant experience and qualifications related to working with people with a learning disability. The registered manager is supported by a deputy manager who also has significant experience in this field. The organisation makes good use of consultancy to provide training and quality assurance functions. There is a clear management structure within the home, staff felt supported by their managers through supervision and also in a practical way. The home established policies and procedures in advance of recruiting staff and used the two weeks before people came to live at the home to disseminate this information. The development of supervision will help to ensure this is continued with existing as well as new staff. Willow House Version 1.10 Page 20 The home had established contacts with various regulatory and inspection bodies prior to opening, and set up contracts to service equipment and maintain safety. One of the people living at the home described a fire drill that had taken place. Records supported this description. 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. Where there is no score against a standard it has not been looked at during this inspection. 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 4 3 3 x Standard No 22 23 ENVIRONMENT Score 3 2 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 3 3 3 3 3 x 3 Standard No Willow House Version 1.10 Score Page 21 LIFESTYLES Standard No 11 12 13 14 15 16 17 Score 3 3 3 3 x x x 31 32 33 34 35 36 x x 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score x 2 2 N/A Standard No 37 38 39 40 41 42 43 Score 3 3 x 3 3 3 x Willow House Version 1.10 Page 22 Are there any outstanding requirements from the last inspection? NO 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. 2. Standard 19 20 Regulation 12,13 13(2) Requirement Timescale for action 30/06/05 3. 23 13(6) The registered person must ensure that people living at the home have access to a dentist. The registered person must 30/06/05 ensure that adequate arrangements are in place for the recording of the administration of medicines. The registered person must 31/05/05 ensure that guidance provided for the protection of people living at the home is unambiguous. 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. 2. 3. Refer to Standard 1 6 36 Good Practice Recommendations The registered person should consider how it can present the service user guide in ways that will make it appropriate for more of the people living at the home. The registered person should develop weekly activity timetables for people living at the home. The registered person should develop the recording of supervision to demonstrate that sessions include an assessment of staff roles in relation to work with people living at the home. Version 1.10 Page 23 Willow House Willow House Version 1.10 Page 24 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex C01 1RJ 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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