CARE HOME ADULTS 18-65
FEARNLEY HOUSE 86 Straight Road Old Windsor Berkshire SL4 2RX Lead Inspector
Stewart Mynott Unannounced 8 July 2005 at 11:00 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. FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION
Name of service Fearnley House Address 86 Straight Road, Old Windsor, Berkshire, SL4 2RX. 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) 01753 863752 CHOICE Mrs Dionne Catherine McGlinchey Care home only (PC) 4 Category(ies) of Learning disability (LD) registration, with number of places FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 17 February 2005 Brief Description of the Service: The home is owned and run by CHOICE Ltd and provides care for people with multiple needs. This is a new home that opened a little over 18 months ago, to provide care for four young residents with learning and physical disabilities. The home is in a bungalow on a main road, with shops nearby. The house is set in a medium size garden with a tarmac car park in the front. The rear is a grassed area with an annexe for an office. There is a summerhouse for use as an educational facility. The house comprises a spacious L-shaped lounge and dining room and kitchen, with four bedrooms and bathrooms and toilets. FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection made in the day, which lasted for 4 hours. During this time the Registered Manager gave a tour of the building and spent time in discussion with the inspector. Time was spent with all of the service users and staff on duty to observe daily life at the home. Care records were also inspected to confirm observations made during the day. What the service does well: 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.
FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 6 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 FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 7 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) Standards 1-5 were not assessed during this inspection. EVIDENCE: FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 8 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 and 9 Service users have comprehensive individual plans describing assessed needs in detail with risk assessments in place to protect service users. EVIDENCE: Three service user plans were inspected. These had been reviewed in the past year and are further reviewed after 6 months. Risk assessments are completed and reviewed with a psychologist at the same time. These are detailed documents and include all aspects of the person’s care including progress on day services and psychologist reports. The key worker completes some of the plan called “all about me”. This is recorded in a person centred manner demonstrating a detailed understanding of the individual. All of the service users have significant difficulties in communication. The Plan includes information to aid effective communication and speech therapy reports. One plan referred to the use of symbols cards around the home and the use of TEACCH boards. A timetable board was also referred to and service users demonstrated the use of the timetable board to the inspector. Staffs were observed to clearly understand how to communicate using these aids as well as using a variety of other methods including makaton and use of objects for reference. Key workers spoken to were knowledgeable about the service user plans and guidelines in place and further review care needs and progress on a monthly basis.
FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 9 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) Standards 11-17 were not assessed during this inspection. EVIDENCE: FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 10 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) 18, 19 and 20 Service users receive an excellent standard of personal, emotional and healthcare support. EVIDENCE: The staff team were observed to treat service users with kindness and respect in all interactions observed. Staff confirmed that personal care is managed using methods to ensure routines, that service users prefer are used to reduce any anxiety. This included the use of emotion cards. These methods were recorded in care records and clearly demonstrate an excellent approach and standard of care given to service users. One service user has received specialist input to ensure aids for restricted mobility are in place. Staff understood their use and importance for independence. Service users health needs are closely monitored. The care records indicated annual health checks and access to local NHS facilities. Specialists are also consulted on a regular basis for more complex medical needs. The home also accesses the psychologists employed within CHOICE. The assistant psychologist visits weekly and reviews behavioural needs and advises staff when needed. Two service users also have weekly reflexology sessions. Service users medication is regularly reviewed and safe systems for medication administration and storage were seen within the home. FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 11 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 and 23 Service users are protected from harm by a dedicated and trained staff team. The complaints policy is robust and ensures service users advocates views are acted upon. EVIDENCE: There is a comprehensive complaints procedure as well as a pictorial complaints process aimed at service users contained in the service users guide. The service users have very limited verbal skills and would find it difficult to complain directly. Staff are clear on observing behaviour and interpreting its meaning and this is reinforced by an effective key worker system. The use of emotion picture cards to explore feelings is used for two of the service users. Both the care records and complaints register record concerns from relatives. These are followed up appropriately with outcomes documented. Staff have received training in protection of adults as well as to assist with behaviour that may challenge the service. Staff spoken to were clear about protection issues and dealing with behaviours ensuring respect and dignity. There are comprehensive procedures in place designed to protect service users from harm, which are regularly reviewed by the psychologist team within the company. FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 12 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 and 30 Service users live in a comfortable homely and well-decorated home that is clean and tidy. EVIDENCE: The Manager gave a tour of the premises and grounds. The home has been open for 18 months and was fully refurbished at that time. This is evident in the standard of décor giving the home a modern and homely feel. The communal areas are light, airy and provide plenty of space to move around. There is a further benefit from a sun lounge opening into the garden which service users were seen to particularly enjoy. There are two bathrooms that meet the needs of the service users. The Manager advised that the shower would be modified in due course to prevent water spilling onto the floor. The service users bedrooms were clean and tidy and personalized to the individual. The laundry facilities were separate from the main house and contained equipment that was suitable for the needs of service users within the home. In the garden there is a summerhouse used for recreational activities including a computer. The home was seen to be very clean. A record for domestic activities was viewed and up to date. A clinical waste system was in use and discrete.
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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) Standards 31 – 36 were not assessed during this inspection. EVIDENCE: FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 14 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) Standards 37-43 were not assessed during this inspection. EVIDENCE: FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 15 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 x x x x x Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 4 x x 3 x
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 3 x x x x x 3 Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score x x x x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
FEARNLEY HOUSE Score 4 3 3 x Standard No 37 38 39 40 41 42 43 Score x x x x x x x H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 16 N/A Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 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. 1. Refer to Standard Good Practice Recommendations FEARNLEY HOUSE H52-H01 S52919 Fearnley House V228826 080705 Stage 4.doc Version 1.30 Page 17 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale, Berkshire RG7 4SA National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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