Inspection on 28/06/05 for Florence House

This inspection was carried out on 28th June 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 3 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Florence House 24/04/07

Florence House 15/02/06

Florence House 24/11/04

Florence House 14/07/04

Florence House 19/03/04

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

CARE HOME ADULTS 18-65 Florence House Florence Street Blackburn Lancashire BB1 5JP Lead Inspector Graham Oldham Unannounced 28 June 2005 10:00 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. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Florence House Address Florence Street Blackburn Lancashire BB1 5JP 01254 59969 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) Alliance in Care Limited Mr Andrew Fred Gibb Care Home only Personal Care (PC) 8 Category(ies) of Learning Disability 8 registration, with number of places Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1 The service must at all times, employ a suitably qualified manager who is registered with the Commission for Social Care Inspection. Date of last inspection 24 November 2005 Brief Description of the Service: Flrorence house is a detached building with accommodation for residents on the first floor. The home is owned by Alliance in care and is family run By Mr and Mrs Gibb. Florence House has eight single bedroom for residents with a learning disability. The communal facilities consist of a lounge, dininrg room, quiet room, arts room and activities room. There is a kitchen, laundry shower room and bathroom. Staff have sleep in facilities. The home has accessible gardens and a car park. Local facilities are within walking distance. The home is situated on the outskirts of Blackburn close to local bus routes. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 28th June 2005. Much of the information gained was obtained from talking to residents and staff members. The views of residents were obtained on a variety of topics. Two residents were case tracked. Case tracking gave the inspector an overall view of the specific care for the individual resident by checking the plans of care, other documentation and talking to residents and staff. Residents at the home were not able to supply detailed answers and were mainly one word replies. The inspector took detailed notes during the inspection, which have been retained as evidence. Staff were directly and indirectly observed carrying out their tasks and interacting with residents. Paperwork examined included plans of care, assessment documentation, policies and procedures or documents relevant to each standard. A tour of the building and grounds was conducted. What the service does well: The plans of care were detailed and contained more information than required giving staff the opportunity to deliver individual care to each resident. There was a good atmosphere at the home to ensure residents were comfortable in their surroundings. Good risk assessments empowered residents. Activities, hobbies, outings and attending work or educational establishments were provided regularly to provide a stimulating environment for residents. Personal support was given in a positive way with the inclusion of resident’s preferences. Staff training and supervision was ongoing to provide staff better knowledge in caring for the resident group accommodated at the home. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 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. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 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 Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 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) 2 and 3 The assessment of residents ensured their needs were met at the home. EVIDENCE: There had been no admissions since the last inspection. Two plans of care were examined during the case tracking process. Assessment documentation contained within the plans of care was thorough and informed residents that their needs and aspirations could be met. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate, in all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 6,7, 9and 10 Residents were able to make decisions about their lives and supported to take calculated risks to maintain their independence. Residents or a family member (where appropriate) were able to contribute to plans of care to maintain their personal goals. EVIDENCE: Two plans of care examined during the case tracking process contained very detailed information about a residents needs. Information contained was above the required standard. Residents or if appropriate family members were consulted on the plans of care and made decisions about their lives and care needs. Residents had signed agreement to their plans of care. Two residents who were involved in case tracking gave a limited account of their care. Plans of care contained information about care needs, hobbies and a social history. Residents assessed needs and personal goals were evident in the plans of care. Risk assessments had been completed for residents. The risk assessments observed during the inspection had been completed for the benefit of residents and allowed residents to retain some independence. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 10 Management held meetings with staff and residents on a monthly basis. Residents were also able to talk to their key workers to ensure they made some decisions about life within the home. Staff were taught about confidentiality issues. Records were maintained with a locked office. Resident’s privacy was respected. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 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 standard(s) 12,13,15,16 and 17 Residents accessed the local community to pursue appropriate activities. Residents were able to maintain friendships or have personal relationships. Resident’s rights were respected at the home. Residents were able to enjoy their meals and mealtimes. EVIDENCE: Residents were going out on the day of the inspection. One resident returning said “I had a good time”. Some activities were held in a group, others for individuals. Other activities were arranged at the home such as pottery, art and woodwork. Activities were appropriate for the group accommodated at the home. Residents accessed gardening projects or attended college ensuring there was involvement with the local community. Families visited the home on a regular basis for some residents. Residents were able to maintain personal relationships if they wished by visiting others or going to group venues. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 12 Two residents case tracked said food was “good”. One further resident said food was “good”. Food was appropriate for the residents accommodated at the home and there was a choice of meal. Residents had access to the kitchen and could assist at mealtimes to help retain life skills. Two staff members gave a good account of resident’s rights. This tied in with the care written in the plans of residents. Resident’s rights were protected. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 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 standard(s) 18, 19 and 20 Residents received appropriate personal care and support. Resident’s health needs were met. The control and administration of medications was well managed, promoting good health. EVIDENCE: Two plans of care were examined during the case tracking process. Staff members were questioned about the care needs of the two residents. Both staff members had a good knowledge of the residents. Personal care and support was provided in suitable way to residents. Resident’s plans of care examined showed residents were attending various clinics for physical and mental health needs. Routine appointments at opticians and dentists were arranged and supervised by staff where necessary. Doctors, nurses and other healthcare professionals such as the Learning Disability outreach team attended the home. Resident’s health was monitored and intervention arranged when needed. Policies and procedures for medication were in place. The inspector examined the medication charts and found them to be clear, up to date and appropriately maintained. Medication procedures protected the health and welfare of residents. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 and 23 Systems were in place to protect residents from abuse. The complaints procedure was available for residents to access and met current Commission for Social Care (CSCI) Guidelines. EVIDENCE: One resident was able to tell the inspector he would tell his key worker if he had any problems or complaints. No complaints had been made to the service or the CSCI since the last inspection. Staff questioned during the inspection were aware of the complaints procedure. The open atmosphere and complaints procedure gave residents an opportunity to complain. Policies and procedures were available for staff to follow for abuse issues. The home used the Blackburn with Darwen adult abuse procedures to follow a local initiative. Members of staff were aware of abuse issues and described their response to abuse to the inspector. Staff had attended an adult abuse course. From the information gained from staff and documentation examined, resident’s protection from abuse was safe-guarded. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 15 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 24 - 30 The home was warm, clean and comfortable. Furnishings and equipment was domestic in style and met residents needs and individual tastes. Toilets and bathrooms were of a type that met residents needs. Shared space was provided to give a variety of activities and uses for residents. EVIDENCE: The inspector conducted a tour of the home during the inspection process. All communal areas and bedrooms were inspected. The home had several communal rooms including a games and arts/crafts room to provide activities. The inspector observed some pottery that had been completed and was told woodworking was next on the agenda. Rooms were clean, tidy and contained sufficient equipment to provide residents with a stimulating environment. The laundry was well equipped to provide a good service to residents. Policies and procedures were in place for the control of infection. Staff had undertaken courses on control of infection, which helped protect the health and welfare of residents. Two residents case tracked said their rooms were “all right” and “its my room” En-suite toilets gave residents some independence. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 16 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, 32, 34, 35 and 36 Residents were supported by a well trained, competent and effective staff team. The recruitment practices at the home were good and protected the health and welfare of residents. Staff were formally supervised. EVIDENCE: Two staff files examined contained all the information required for recruitment standards. Files showed further certificates staff had gained for various training undertaken. Recruitment procedures ensured a thorough check was made prior to employing any new staff. Both staff members questioned had undertaken training of one form or another. A training and development profile was available at the home to have a break down of care courses and where staff needed to receive training. Most staff had taken an accredited medication course. Other staff members had undertaken training for first aid, food hygiene, fire safety, anger aggression and breakaway techniques amongst other courses. The training undertaken ensured staff had the knowledge to look after the resident group accommodated at the home 50 of staff had not achieved NVQ qualifications. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 17 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 37, 38, 39 and 42 The home was well run but the manager had not achieved the relevant qualifications. The processes of managing the home were open and transparent. Quality Assurance systems were in place but did not meet the required standard. The health and safety of residents was protected. EVIDENCE: The registered manager held qualifications, which ensured care for the residents accommodated at the home was appropriate. The registered manager was completing the Registered Managers Award to fully comply with registration requirements. Staff told the inspector the management were approachable . Staff “felt very much supported” and “we get a lot of support”. Staff meetings were held at regular intervals. Management held recorded meetings with residents and took note of their wishes. Residents benefited from leadership and management at the home. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 18 Not all aspects of Quality Assurance had been completed at the home. When completed the views of residents, family, friends and stakeholders will assist the registered manager in shaping the home to the benefit of residents. Staff training, policies and procedures and the maintenance of gas and electrical appliances protected the health and welfare of residents’. Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 19 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 3 x x Standard No 22 23 ENVIRONMENT Score 3 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 4 3 x 3 3 Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 3 3 3 3 3 Standard No 11 12 13 14 15 16 17 x 3 3 x 3 3 3 Standard No 31 32 33 34 35 36 Score 3 2 x 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Florence House Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x 2 x x 3 x F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 20 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. 2. Standard YA32 YA37 Regulation 18(a) 9(2)(b) Requirement The registered manager must ensure staff attain the relevant NVQ qualifications. The registered person must ensure the registered manager achiven the relevant NVQ qualifications. The registered manager must ensure quality assurance systems meet current standards. Carried forward from 31/3/05 Timescale for action 31/12/05 31/12/05 3. YA39 24(1) 30/10/05 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. Refer to Standard Good Practice Recommendations Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection 1st Floor, Unit 4 Petre Road, Clayton-Le-Moors Accrington Lancashire. BB5 5JB 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 Florence House F57 F07 S58811 Florence House V224347 280605 Stage 4.doc Version 1.30 Page 22 - 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. 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