Inspection on 18/04/07 for Fledglings Court

This inspection was carried out on 18th April 2007.

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

Fledglings Court 08/03/06

Fledglings Court 16/12/05

Fledglings Court 08/02/05

Fledglings Court 24/09/04

Fledglings Court 23/02/04

Similar services:

Larch Avenue

Alderson Road 12

Cranworth Close Registered Care Home

The Cornerstone

John Street Nursing Home

Pennine Camphill

Whitwood House

Whitwood Hall

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

CARE HOME ADULTS 18-65 Fledglings Court 11 Beverley Road Market Weighton East Yorkshire YO43 3JN Lead Inspector Rob Padwick Unannounced Inspection 18th April 2007 2:00 DS0000019670.V336473.R01.S.doc Version 5.2 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 DS0000019670.V336473.R01.S.doc Version 5.2 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. DS0000019670.V336473.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Fledglings Court Address 11 Beverley Road Market Weighton East Yorkshire YO43 3JN 01430 871744 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) Joseph Rowntree Housing Trust Mrs Patricia Stainton Care Home 14 Category(ies) of Learning disability (14) registration, with number of places DS0000019670.V336473.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 8th March 2006 Brief Description of the Service: Fledglings Court is a purpose built bungalow style residential home for up to fourteen people with learning disabilities. The building provides single storey accommodation and all bedrooms are for single use and equipped with ensuite toilet facilities. The home is located a short walk from the town centre of Market Weighton, close to a number of local amenities including public transport, post office, pubs, churches, shops and a snooker club. The home is managed by the Joseph Rowntree Housing Trust. The standard fees charged by the home range from £338.50 to £731.37 with additional charges made for hairdressing, chiropody, toiletries etc. Fledglings Court provides information to residents about its facilities in its Statement of Purpose and Service User Guide. DS0000019670.V336473.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection visit for this service lasted for 4 hours and during this period, time was spent talking with people living in the home and observing their daily lives. Other time was spent looking at care plans and other records and talking to staff. This inspection visit also included a tour of the building. A Pre Inspection Questionnaire asking for information about the home was sent to the manager before the visit and information from this was included as part of the inspection process. Other material used included notifications received by the Commission for Social Care Inspection about serious incidents that had taken place in the home. Questionnaires were sent to people associated with the home, including those living there, their relatives and Health and Social Services staff. All of those that were returned expressed high levels of satisfaction with the service. What the service does well: What has improved since the last inspection? What they could do better: Whilst the service generally provides excellent outcomes for people, a number of recommendations have been identified in this report, in order to maintain and improve the service further. DS0000019670.V336473.R01.S.doc Version 5.2 Page 6 Some risk assessments should be developed further, so that staff have better information on what to look out for and do about identified issues. Key worker recording should be clearer, to show how people who live in the home have benefited from staff involvement and how they have been. Staff checked against the Protection of Vulnerable Adults (POVA) list, should only in exceptional circumstances be allowed to work in the home before a satisfactory Criminal Records Bureau check has been obtained for them and internal checks should be made of staff references, to make sure that they have been received from two separate sources. The home’s Quality Assurance systems should be developed to include regular checks of various parts of the service and staff responsible for the administration of medication should continue to receive accredited training in this. Information about the home should be updated, so that people thinking of moving in are informed of recent changes in the management arrangements for the home. 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. The summary of this inspection report can be made available in other formats on request. DS0000019670.V336473.R01.S.doc Version 5.2 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 DS0000019670.V336473.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1 and 2 People who use this service experience good outcomes in this area. The needs of people living in the home had been assessed to ensure that the service was able to meet them. Information about the home needed to be updated slightly, so that people have accurate information to help them make a decision about moving in. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Most of the people at the home had been living there for a number of years. A pre admission assessment for the most recently admitted person had been obtained from his social worker before he had moved in, so that it was possible for the home’s manager to make a decision about whether the home was able to meet his needs. Information about another person, who was due to move in after staying there for a series of short “respite” stays was available, so that staff were aware how to meet their care needs. The needs of the people living in the home had been reviewed on both an ongoing and more formal annual basis, with Social Services staff and other people who know them well contributing to the process. Staff indicated that “Lifestyle” reviews were arranged for each individual and that information from DS0000019670.V336473.R01.S.doc Version 5.2 Page 9 these was developed into an Individual Programme Plan for them. Evidence was seen that the reviews were highly person centred and based on a full assessment of the individual’s needs and wishes. Information about the service was available in the Service User Guide and Statement of Purpose to help prospective residents make an informed decision about moving in to the home. However, some of this needed to be updated, to reflect a recent change in the management arrangements of the Provider organisation. DS0000019670.V336473.R01.S.doc Version 5.2 Page 10 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7,and 9 People who use this service experience good outcomes in this area. People in the home were very well involved in the planning of their own care, but better information was needed to help staff safeguard them from possible risks. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information about the social, emotional and physical health needs of the people living in the home had been developed into individual care plans. Those spoken to confirmed that they were aware of these and indicated that they had been very much involved in the process of deciding what was to be included in them. The care plans were person centred and highly individualistic and reflected the support needs on a range of issues relevant to the person concerned. Care plans were being regularly reviewed and amended, to ensure they were up to date and assessments concerning the management of identified issues of risk for the individuals accommodated, were included in these. However, some of the information about these was not very clear and needed more detail about what staff should look out for and DS0000019670.V336473.R01.S.doc Version 5.2 Page 11 do in these matters. A recommendation is made about this. Time spent with individual people was documented by their “keyworker”, however staff recording about this issue of practice was considerably varied, and it was not always possible to gain a clear picture about how the resident concerned had been or had benefited from such involvement. A further recommendation is made in this matter. A visiting parent indicated how her son had matured and developed since moving to the home and positive comments were received from her on his increased sense of independence. DS0000019670.V336473.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use this service experience excellent outcomes in this area. The rights and responsibilities of people living in the home are respected and they are well supported by staff to lead a lifestyle of their choice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The two care plans and associated records that were inspected in detail indicated that people in the home were being supported to achieve their own individual goals and aspirations. Those living at living at Fledglings Court have a mixed range of needs and abilities and their age’s range from the late twenties to early sixties. At the start of this inspection visit, most of them were out at either day centres or at work, but others who were in confirmed that they were able to lead a lifestyle of their own choosing and liking. People talked about various activities that they enjoyed, including a “Hands and Voice” (music and signing group) and regular swimming and snooker sessions and discussion with staff indicated that other things were determined by individual choice. Positive relationships were observed to exist within the DS0000019670.V336473.R01.S.doc Version 5.2 Page 13 home, with staff providing sensitive support to those requiring it to carry out light everyday tasks that had been agreed as part of their individual plans, such as washing and clearing up after their meals. One person described how staff had helped her to visit her sister, whilst a visiting relative confirmed that she was “very happy” with the service and welcomed to visit at any time. Evidence was seen that people living in the home were supported to have at least one annual holiday and transport was available for use on visits and trips out. A comment received from a member of professional staff indicated that the home’s staff were “very caring” and discussion with those on duty confirmed that they were committed to meeting the needs of those accommodated and to doing their jobs. People were provided with a variety of healthy and nutritious meals and those spoken to stated that the food was “good” and confirmed that they were able to help decide what was to be served. DS0000019670.V336473.R01.S.doc Version 5.2 Page 14 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use this service experience good outcomes in this area. Good links are maintained with health care professionals in the community and a variety of training had been provided to staff to ensure that the individual health and personal care needs of the people living in the home were met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: People confirmed that they received their health and personal care support in a way that they were happy with and case files inspected contained information about this, which had been agreed as part of the Individual Programme Planning process. Separate diary record books contained evidence of regular staff documentation and case files inspected confirmed that health conditions and needs were being monitored. A Community Learning Disability Nurse indicated that that staff worked well in maintaining close links with local health professionals and those on duty confirmed that a variety training relating to the needs of the people in the home had been provided to them. DS0000019670.V336473.R01.S.doc Version 5.2 Page 15 The deputy manager was in the process of providing training to a new staff member on the home’s medication procedures and discussion with her confirmed that those responsible for this aspect of practice had completed a course on the safe handling and administration of medication. A recommendation is made in this matter. A random check of the medication records in the home confirmed that these were being accurately kept. DS0000019670.V336473.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use this service experience good outcomes in this area. The concerns of people living in the home are taken seriously and they were being safeguarded from abuse by staff that had been trained in this aspect of practice. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Observation of the people living in the home and discussion with them confirmed that they were happy with the service and that staff listened to their views properly. Policies and procedures were available to ensure that those accommodated were safeguarded from abuse and that their concerns or complaints were taken seriously. The home’s complaints book contained no entries since the last inspection and the Commission for Social Care Inspection had received no complaints about the service in this time. A minor amendment was needed to the complaints policy since CSCI office arrangements for the home had changed and the deputy manager agreed to do this straight away. Staff had a good understanding of the home’s policies concerning the protection of vulnerable adults and those spoken to confirmed that they had received training on this aspect of practice. Records are kept of money held on behalf of the people living in the home and a random check of these indicated that they were being accurately maintained. Evidence was seen that all of those accommodated had their own individual building society account. DS0000019670.V336473.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use this service experience excellent outcomes in this area. The home was being well maintained and was clean and comfortable, so that people living in the home had an environment that safely met their needs. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home was maintained to a high standard and was clean and comfortable throughout. Good access around the building was available for wheelchair users and the communal areas were bright, airy and spacious. Bedrooms were individually furnished with posters and items of domestic equipment and specialist aids and adaptations had been obtained to maximise the independence of those accommodated. Staff indicated that they had been provided with training relating to hygiene control measures and observation of them confirmed that these were being followed appropriately. From discussion with staff and those accommodated, it was apparent that they took a pride in the home and inspection of the maintenance book confirmed that regular checks were being carried out. DS0000019670.V336473.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 People who use this service experience good outcomes in this area. The staff that had received training to help them meet the needs of the people in the home, but a closer attention to the implementation of the home’s recruitment procedures would safeguard them from harm better. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Information provided by the manager as part of the inspection process indicated that staff had been provided with a good variety training relating to the needs of the people living in the home. Those on duty were observed to be confident in their skills and discussion with them indicated that they were committed to doing their jobs. Staff stated that their was “loads of training” and inspection of their individual files confirmed that this had been delivered according to both their own development needs and the care needs of people living at the home. The minutes of monthly staff meetings confirmed that issues relating to the needs of those in the home were regularly included and discussion with staff indicated that their values and attitudes accorded with those of the home. Information provided by the manager confirmed that over 50 of the staff team had obtained an NVQ in care at level 2 or above and DS0000019670.V336473.R01.S.doc Version 5.2 Page 19 discussion with the deputy manager indicated that all but the two latest staff members possessed this qualification. Recruitment policies and procedures were in place to ensure that staff were safe to work with the people accommodated and discussion with the deputy manager indicated that the views of people living at Fledglings Court were included as part of this process. Evidence of past and previous career history was available in all of the staff files that were seen, however the files of two of the most recently employed staff contained evidence that they had been employed following Protection of Vulnerable Adult (“POVA First”) checks, and the required Criminal Records Bureau disclosures for them had only been received later. The deputy manager was strongly reminded that this whilst this is acceptable in exceptional circumstances, this practice should not be carried out as a standard rule. A recommendation is therefore made about this. Two separate references had been obtained for one new staff member that were both signed by the same person. A subsequent assurance was obtained from the provider organisation’s personnel department, which confirmed that two separate requests had indeed been made. The provider organisation’s personnel department acknowledged this error and indicated that this had been a genuine oversight. A further recommendation is made in this matter to ensure that people who live in the home are protected from potential harm. DS0000019670.V336473.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use this service experience excellent outcomes in this area. The management of the home provides a supportive environment so that the health, safety and welfare of people in the home are met. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Despite the manager being on leave at the time of this inspection visit, it was clear that the home was being well run and in the interests off the people living there. Staff were observed to have strong relationships with the people living at Fledglings Court and it was clear that the management style had equipped them with the confidence and skills to do their jobs. The manager is well qualified and has substantial experience of managing the home and is assisted in this task by a deputy manager, who is also well trained. Members of professional staff in the community commented very highly on the skills and abilities of the home’s manager and staff in the home expressed a great DS0000019670.V336473.R01.S.doc Version 5.2 Page 21 confidence her approach. The minutes of staff meetings and people living in the home indicated good levels of communication and inspection of staff records confirmed a strong emphasis on the importance of staff training. People living in the home were able to participate to the home’s quality assurance systems and evidence was seen that their views had been considered and acted upon. A subsequent discussion with the home’s manager indicated that the provider organisation is currently looking at ways to develop this further and a recommendation is made that this should include regular audits of various aspects of the home. A variety of safety checks were being regularly carried out and inspection of a random sample of the home’s maintenance certificates confirmed that these were up to date. DS0000019670.V336473.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 4 25 X 26 X 27 X 28 X 29 X 30 4 STAFFING Standard No Score 31 X 32 4 33 X 34 3 35 X 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 4 X 3 X LIFESTYLES Standard No Score 11 X 12 4 13 4 14 X 15 3 16 4 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 4 X 3 X X 3 X DS0000019670.V336473.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/A 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 DS0000019670.V336473.R01.S.doc Version 5.2 Page 24 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 YA1YA1 Good Practice Recommendations The registered person should update the home’s statement of purpose and service user guide to reflect recent changes in the Provider organisation’s internal management arrangements for the home. The registered person should ensure that risk assessments for those accommodated provide staff with information on what to look out for and do in respect of identified issues. The recording of key worker time should be developed to provide clear information about how individual residents have been and benefited from staff involvement. The registered person should continue to ensure that staff responsible for the administration of medication have received accredited training in this aspect of practice that has been externally assessed. The registered person should ensure that the practice of allowing staff checked against the Protection of Vulnerable Adults (“POVA First”) list are only in exceptional circumstances permitted to work in the home before a satisfactory Criminal records bureau check is received for them. Internal checks should be made to ensure that staff references have been received from two separate sources. The registered person should ensure that the home’s quality assurance systems are further developed and include regular audits of various aspects of the home. 2 YA6YA6 3 YA20YA20 4 YA34YA34 5 YA39YA39 DS0000019670.V336473.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Hessle Area Office First Floor, Unit 3 Hesslewood Country Office Park Ferriby Road Hessle HU13 0QF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000019670.V336473.R01.S.doc Version 5.2 Page 26 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!