CARE HOME ADULTS 18-65
1-2 Flax Cottages Scotland Gate Choppington Northumberland NE62 5SR Lead Inspector
Anne Brown Announced 24 October 2005: 09:30 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. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service 1-2 Flax Cottages Address Scotland Gate Choppington Northumberland NE62 5SR 01670 530247 N/A communityhome@flaxcottages.fsworld.co.uk Northgate & Prudhoe NHS Trust 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) Miss Jacqueline Land CRH 9 Category(ies) of LD Learning Disability - 5 registration, with number LD(E) Learning Disability - over 65 - 4 of places 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: N/A Date of last inspection 25/4/05 Brief Description of the Service: Flax Cottages is a purpose built home for nine people with severe learning disabilities who have moved into the community from Northgate Hospital.The home is located in Choppington, approximately two miles from the town centre of Bedlington and is in close proximity to local shops, pub and community centre.The home comprises two connecting bungalows for nine service users in total. One bungalow contains five bedrooms and the second contains four bedrooms. All service users have their own bedroom. Both bungalows have their own lounge, dining room, kitchen and bathroom and toilet facilities.There are two large gardens to the rear of the premises that are fully accessible to the service users. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was announced and took place over four hours. A tour of the premises took place and the care records were inspected along with the fire log book, accident book, maintenance contracts and minutes of meetings held in the home. Discussions were held with the manager and four members of staff. Seven service users were present. What the service does well: What has improved since the last inspection?
Since the last inspection a new manager has been appointed in the home and is applying to become registered with the CSCI. The manager has booked in-house specialised training for the staff team and formal supervision sessions are taking place on a regular basis. Redecoration and new bedding and curtains have been provided in some bedrooms. An annual plan has been produced which identifies the areas for improvement during the coming year. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 6 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. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 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 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 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 and 5 A statement of purpose and service user guide has been produced which gives people information about the home helping them to make choices. Statement of terms and conditions are issued which protects service users’ rights. EVIDENCE: Each service user has a copy of the service user guide in their bedroom. The staff confirmed that they discuss these documents with the service users on a regular basis. Copies of the terms and conditions were available on the case files. These are signed by the service users and/or their representatives. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 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 and 10 There are good arrangements in place to ensure that service users’ health and social care needs are met. Detailed care plans ensure the staff team are fully informed. Confidentiality is respected in the home. EVIDENCE: Health and social care needs are clearly addressed and the staff team are fully informed. All appointments with health care professionals are recorded in the care plan and an ‘OK’ health check is carried out annually. Service users are well supported by staff and the necessary levels of support are recorded in the detailed care plans that show the level of care and support the staff need to provide. A comprehensive confidentiality policy is in place and is part of the staff induction training programme. Each case file contains a statement to remind the staff that the information is confidential. All personal records are held in a secure location in the home. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 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, 15 and 17. Service users are able to participate in a variety of activities, which are reviewed. Links with the community and opportunities to participate in social and personal development activities had reduced due to staff shortages. Visitors are made welcome and residents are supported to maintain contact with family and friends as they wish. A balanced and varied selection of food is available that meets service users’ tastes and choices as well as special dietary needs. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 11 EVIDENCE: The inspector examined the activity schedules for the residents. The activities are reviewed to ensure service users are given the opportunity to access activities of their choice. The staff stated that some activities had not always been possible due to staff shortages and not all service users were able to be escorted on holiday. The staff are currently looking at appropriate breaks for the service users which will be arranged when new staff are appointed in the home. Music and arts and crafts sessions are held in the home and one service user enjoys knitting and embroidery. They were enjoying embroidering during the inspection. During the inspection the service users were spending time in their own bedrooms and accessing various parts of the home. Staff were seen to be respecting the service users’ privacy and dignity. They were observed to be spending time with the service users. Visitors are encouraged to participate in events taking place in the home. Staff assist the service users to maintain contacts with their family and friends. They have recently attended a birthday party at the local community centre held for a service user living in a nearby home. Six weekly menus are operated and an alternative is offered at every mealtime. The likes and dislikes of the service users are recorded and staff try to introduce new food to the menus. Pictorial menus are also used to ensure all service users are given a choice of food at every mealtime. Nutritional advice is available from the Trust and the service users are weighed on a regular basis. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 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) 20 An appropriate system is in place for dealing with medications to ensure they are appropriately stored and administered. EVIDENCE: A comprehensive policy and procedure is in place for dealing with medications. Training has been given to all staff who deal with medications and the manager confirmed that advice is readily available from the contracting pharmacist. Medications are stored in appropriate facilities. A random sample of medication records and the system for storage and handling medications were looked at and found to be appropriate. Photographs of the residents have been placed on their medication administration records as an additional security measure. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 13 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. There is an appropriate system for dealing with complaints to ensure complaints are effectively dealt with. Policies and procedures ensure that the service users are protected from different forms of abuse. EVIDENCE: A complaints procedure was available and this is included within the service user guide. No complaints have been received since the last inspection. There are comprehensive policies and procedures in place to ensure service users are protected from abuse. These are discussed at staff induction training sessions. All staff members have booked on a training course run by Northumberland County Council. Five staff members have completed this training. Appropriate records, receipts and signatures are retained when dealing with monies held on behalf of the service users. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 14 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 29. The facilities and décor within the home are good, providing service users with an attractive and homely place to live. Specialist equipment is provided to ensure the individual needs of service users are met. EVIDENCE: An inspection of the premises was carried out. All areas of the home were homely, comfortable and well furnished. A new settee has been provided in one lounge. Bungalow 1 would benefit from a new carpet in the hallway as the present carpet is stained. The décor in the bathroom in this bungalow is showing signs of wear and tear and would benefit from redecoration. The manager ensures that specialist equipment is provided in consultation with an occupational therapist. A specialist chair has recently been provided for one service user and another is being assessed. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 15 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) 31, 35 and 36. Minimum staffing levels are met, however, there have been some staff vacancies in the home which has led to residents having fewer opportunities to enjoy activities outside of the home. Regular supervision sessions take place and the training needs of the staff are identified. EVIDENCE: On the day of the inspection the manager, two assistant team leaders, three home support workers, two enablers and one domestic were on duty. The staff confirmed that recent staff shortages and sickness had made it difficult to cover the rotas. The Trust are currently in the process of employing two parttime home support workers. All staff have a training analysis sheet and new courses have been identified to meet specialist needs. The staff confirmed that they receive appropriate training to carry out their roles efficiently. They also stated they receive regular supervision sessions from the manager. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 16 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) 38, 40, 41 and 42 The manager has a clear development plan for the home. Policies and procedures are in place to ensure the service users’ rights are safeguarded. Recording systems promote the rights and best interests of the service users. There are systems in place to promote health and safety. EVIDENCE: The manager recently appointed to the home has experience of working with adults with learning disabilities. She holds a nursing qualification and is undergoing training to achieve NVQ Level 4 in management. Staff meetings are held on a monthly basis at Northgate Hospital and house meetings are held in both bungalows on a weekly basis. The service users are encouraged to participate in these meetings. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 17 Comprehensive policies and procedures are available in the home and are reviewed on a regular basis. Staff sign to confirm they have read and understood any new policies and procedures which are introduced. The recording systems were up to date and well recorded. The fire door guards, which hold the doors open and close when the fire alarm is activated, have not been fitted. Staff continue to chock doors open. This requirement was made in April 2004 and must now be dealt with immediately. Risk assessments have been put into place. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 x x x 3 Standard No 22 23
ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10
LIFESTYLES Score 3 x x x 3
Score Standard No 24 25 26 27 28 29 30
STAFFING Score 2 x x x x 3 x Standard No 11 12 13 14 15 16 17 3 3 3 x 3 x 3 Standard No 31 32 33 34 35 36 Score 3 x x x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
1-2 Flax Cottages Score x x 3 x Standard No 37 38 39 40 41 42 43 Score x 3 x 3 3 2 x B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 19 YES 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 42 Regulation 23(4) Requirement Self-closing devices linked to the fire alarm system must be fitted to doors that are currently chocked open. (Previous timescale of April 2004 not met). Timescale for action 30/11/05 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 24 25 Good Practice Recommendations New carpet should be provided in the hallway in bungalow 1. Bathroom in bungalow 1 should be redecorated. 1-2 Flax Cottages B53 B03 S644 Flax Cottages V249579 241005 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Northumbria House Manor Walks Cramlington NE23 6UR National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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