Inspection on 10/12/05 for Fishermead Boulevard (104)

This inspection was carried out on 10th December 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

Fishermead Boulevard (104) 23/10/09

Fishermead Boulevard (104) 06/12/06

Fishermead Boulevard (104) 25/01/06

Fishermead Boulevard (104) 24/03/05

Fishermead Boulevard (104) 14/07/04

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Orchard,The

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Treloar College

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

CARE HOME ADULTS 18-65 Fishermead Boulevard (104) Fishermead Milton Keynes Bucks MK6 2AP Lead Inspector Chris Schwarz Unannounced Inspection 10th December 2005 09:35 Fishermead Boulevard (104) DS0000015057.V270338.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 Fishermead Boulevard (104) DS0000015057.V270338.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. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Fishermead Boulevard (104) Address Fishermead Milton Keynes Bucks MK6 2AP 01908 670234 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) The Fremantle Trust Mrs Susan McMillan Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for 6 people with a learning disability with one person over the age of 65 with a mental disorder also. 24th March 2005 Date of last inspection Brief Description of the Service: 104 Fishermead Boulevard is located close to the city centre in Milton Keynes. There are good shopping, leisure and transport facilities close by. The home is a large, detached property with accommodation on two floors. There is one downstairs bedroom with the remaining five on the first floor. The service user group at the time of this visit was an all male one, with various care needs and covering a range of ages. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was conducted on a Saturday, from 9.35 am until 12.55 pm. It included discussion with the three service users home at the time, examination of some of the home’s required records and discussion with staff. A tour of the building was also conducted. The overall feel of the inspection was positive, with clear evidence of service users having choice in their care and opportunities to lead independent lifestyles. What the service does well: A new service user had been appropriately placed at the home and staff were meeting his care needs effectively. Care plans were in place for each person, to ensure that needs were adequately reflected. There was evidence of regular reviewing. There was good evidence of service users making decisions and having choices, to promote independence and self-worth. Acceptable risk taking is also part of the home’s philosophy. Service users lead active lives with a range of opportunities available to them during the week and at weekends. Hobbies are actively pursued, especially supporting football teams. Good use is made of the local community and service users maintain links with families and friends. Health care needs are well met, with routine appointments attended as well as preventative screening and optional care such as influenza vaccination. Medication is well managed and appropriately stored at the home. There are effective complaints, whistle blowing and adult protection procedures in place and the provider had responded appropriately to adult protection concerns. A homely, well-maintained and comfortable environment has been created, which is kept clean and hygienic. There are competent and trained staff working at the home, led by an effective manager. The provider regularly monitors quality of care to ensure that good standards of care are being maintained. Health and safety is given due care and attention to keep staff, service users and visitors safe. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 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. Fishermead Boulevard (104) DS0000015057.V270338.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 Fishermead Boulevard (104) DS0000015057.V270338.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): 2 The home ensures that assessments of prospective service users are carried out in order that their needs can be met. EVIDENCE: A new service user had been admitted to the home since the last inspection. A care plan was in place outlining his needs and information such as his preferred name was included and subsequently used by staff. The service user said he liked living at the home. Fishermead Boulevard (104) DS0000015057.V270338.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 and 9 Care plans are in place, outlining service users’ needs in order that these can be met. Service users are able to make decisions, in order that they have choice and fulfilment. Service users are enabled to take risks, in order that they are as independent as possible. EVIDENCE: Care plans were in place for each of the people living at the home. The sample examined were up-to-date with accompanying risk assessments and evidence of reviews. Signatures and dates were in place and review sheets had been added to the folders to prompt monthly evaluation. Service users got up when they were ready and had exercised choice of what to wear. They were asked what they wanted for breakfast and individual choices prepared for them. One person had made himself a drink and another was observed administering his own supplementary medication. After Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 10 breakfast one of the service user’s walked into town to do some shopping and top up his mobile telephone. Cards were used to facilitate communication with one service user. Review notes written by a care manager showed that verbal communication had improved for another service user. Fishermead Boulevard (104) DS0000015057.V270338.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, 15, 16 and 17 Service users have opportunities for personal development, in order to lead fulfilled and independent lives. Service users have a range of activities and pastimes appropriate to their age and interests, to provide stimulation and variety. Service users are part of the local community, promoting independence and self-worth. Service users are enabled to maintain appropriate relationships, in order that important social links are continued. Service users’ rights and responsibilities are upheld, in order that they have a say in their care. Service users are offered a good diet, in order that nutritional needs are met. EVIDENCE: Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 12 Service users are involved in various activities during the week and at weekends. Day services such as Thrift Farm, Tower Drive, Snaps and Beanhill are used. One person’s review notes listed a range of sporting activities as well as evening clubs and groups and there are some dedicated football fans living at the home. One had recently watched Manchester United play. Most of the service users have verbal communication skills and can make their needs readily known. Staff responded to non-verbal cues for one person and used picture cards to indicate preferences and check responses had been understood correctly. Service users make good use of the facilities close by; shops in the city centre are within a ten minute walk and some people go into the centre unaided. Contact with families and friends is good. Three people were staying with their families over the weekend. One person is enabled to maintain a relationship with support from staff as necessary. The daily routine of the home was flexible and unrushed, with breakfast prepared at service users’ pace accompanied by an unobtrusive radio playing. Preferred form of address was being used with service users and there was good interaction between staff and service users. One person opted to spend time in his room listening to music. Cooked breakfast was prepared individually, with service users saying what they would like. Discussion took place regarding what meat they would like for Sunday lunch in order that staff could make appropriate arrangements, plus a check on which vegetables they preferred. Records of food consumed by service users were varied, with a range of different meals provided for them. The home was managing to provide appropriate meals for a service user with coeliac disease. Fishermead Boulevard (104) DS0000015057.V270338.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, 20 Staff provide personal support in ways which service users prefer, in order that their needs are best met. Staff promote service users’ physical and emotional health, to keep them healthy and well. Medication practice is well managed at the home, to ensure that service users health and well-being are promoted. EVIDENCE: One person required full assistance with personal care and this was carried out in private, with conversation throughout on what needed to be done and checking that it was done effectively. Provision of equipment to assist with daily living tasks has been taken into account, according to needs, and was used by staff. One of the service users had returned from a short stay in hospital the previous evening. Records showed that staff are promoting attendance of regular, routine health care appointments as well as preventative screening, such as Well Man checks, and optional care such as influenza vaccination. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 14 Medication was safely stored in a locked cabinet which was securely attached to the wall. Medication administration records were well maintained with signatures alongside prescribed dose times. A recommendation is made to ensure that the strength of tablet is noted where staff add “as required” items, such as paracetamol. There had not been any deaths at the home during the period under review. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 15 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 There are effective complaints procedures in place, to listen to the views of service users. Appropriate arrangements are in place to protect service users from risk of abuse, to promote their safety and well-being. EVIDENCE: The Fremantle Feedback complaints procedure is in place at the home, which contains the contact details of the Commission for Social Care Inspection for reference. A log book is maintained in the office, with service users’ comments included although none were evident since February this year. Where complaints were noted, there was evidence of matters being resolved satisfactorily. The home has whistle blowing and Protection of Vulnerable Adults procedures in place. Staff training records showed that there had been input on abuse awareness in June this year and the manager is an accredited Protection of Vulnerable Adults trainer. The provider had responded appropriately to two incidents earlier in the year regarding a member of staff who is no longer employed at the home. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 16 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 and 30 A homely, comfortable and well-maintained environment has been created for service users, providing suitable and safe accommodation. The home is clean and hygienic, guarding against the risks of infection and ill health. EVIDENCE: All parts of the home other than two locked bedrooms were seen. Communal areas were bright and warm and decorated to a good standard. Bedrooms were personalised and lived in. The lounge was looking particularly coordinated and comfortable and three Christmas trees and accompanying decorations had been put up around the building. Bathrooms and toilets were appropriately stocked with toilet roll and hand washing items. The laundry was under control and the kitchen clean and tidy. No offensive odours were evident. Fishermead Boulevard (104) DS0000015057.V270338.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): 32 and 35 Competent and qualified staff work at the home, to ensure that service uses are in good hands. Service users benefit from a trained staff team, to ensure that care needs are adequately met. EVIDENCE: One person was initially on duty at the start of the inspection, joined at 10.00 am by a second member of staff. Both had worked at the home for some time and knew service users well, demonstrating an understanding of care needs and promoting choice and individuality for service users. Both were up-to-date with mandatory training and overall, training records showed that several staff had updated their knowledge during the year. There had been input on health related courses such as oral health and dsyphagia. No agency staff were being used at the home at the time of this visit. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 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): 37, 39, 40 and 42 The home is effectively managed, to ensure that care needs are consistently met. There is regular monitoring by the provider, to ensure that the home is efficiently run and providing good standards of care. Records are well-maintained, to safeguard service users’ best interests. There is effective management of health and safety, to keep service users, staff and visitors safe. EVIDENCE: The manager is experienced with the service user group and has achieved the Registered Manager’s Award this year. She is registered with the Commission and training records showed that she undertakes periodic training to refresh skills. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 19 Regular monthly visits have been undertaken by the provider to evaluate quality of care and reports of these visits are routinely forwarded to the Commission. An audit of care had been carried out in the summer, the report of this exercise was not seen on this occasion but will be requested next time. There had been improvements to record keeping, with out of date information archived and folders brought up-to-date and arranged in good order in the office. A range of health and safety checks is carried out at the home. Checks are made of fridge and freezer temperatures and cooked food core temperatures. These were satisfactory and demonstrated appropriate and safe storage and cooking of foods. Date labels were added to opened packaging in the fridge. The fire log showed that routine tests are carried out and that maintenance and servicing takes place. Additionally a fire based risk assessment was in place and there were assessments where service users do not respond to the fire alarm. Generic and individual risk assessments were in place. Protective gloves and antibacterial hand wash were available around the building. Records were being maintained of any accidents and incidents around the home and appropriate action had been taken in response to these. A recommendation is made is make safe the television aerial cable trailing in front of the bed in the downstairs room, which could be a tripping hazard. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 20 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 3 x x x Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 x 3 x Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x X X X x 3 LIFESTYLES Standard No Score 11 3 12 3 13 3 14 x 15 3 16 3 17 Standard No 31 32 33 34 35 36 Score x 3 x x 3 x CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Fishermead Boulevard (104) Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 3 x 3 x 3 3 x DS0000015057.V270338.R01.S.doc Version 5.0 Page 21 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. 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 2 Refer to Standard 20 42 Good Practice Recommendations The strength of medication is to be added to the medication administration records, for example paracetamol 500mg. The television aerial cable trailing in front of the bed in the downstairs room should be made safe. Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection Aylesbury Area Office Cambridge House 8 Bell Business Park Smeaton Close Aylesbury HP19 8JR 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. Extracts may not be used or reproduced without the express permission of CSCI Fishermead Boulevard (104) DS0000015057.V270338.R01.S.doc Version 5.0 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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