Inspection on 31/01/06 for Florence Villa and Independent Unit

This inspection was carried out on 31st January 2006.

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 no outstanding requirements from the previous inspection report, but made 5 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Florence Villa and Independent... 20/11/08

Florence Villa and Independent... 21/11/06

Florence Villa and Independent... 13/07/05

Florence Villa and Independent... 07/12/04

Florence Villa and Independent... 27/07/04

Florence Villa and Independent... 02/03/04

Florence Villa and Independent... 03/11/03

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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 Florence Villa & Independent Unit 107 Trentham Road Dresden Stoke-on-Trent Staffordshire ST3 4EG Lead Inspector Katie Claffey Unannounced Inspection 31 January 2006 17:20 Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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 Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Florence Villa & Independent Unit Address 107 Trentham Road Dresden Stoke-on-Trent Staffordshire ST3 4EG 01905 459 800 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) Strathmore College Limited Care Home 18 Category(ies) of Learning disability (16) registration, with number of places Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 4 of whom may be LD, minimum age 16 years. Staffing levels will be reviewed to represent the increase in numbers Date of last inspection 13th July 2005 Brief Description of the Service: Florence Villa is part of a specialist residential college catering for young people with learning disabilities aged 16 to 25 years; significantly, four may be under 18 years old and therefore additional, supplementary National Minimum Standards also apply. At present, about 12 other students attend on a day basis. Young people stay at the college for a maximum of three years and attend for between 38 and 52 weeks per year, depending on their contract. There are two other homes that are also part of the college and a shop, which are owned by Craegmoor Healthcare. It is registered with the DfES as well as the CSCI and has achieved Investors in People status. The mission of the College is to enable individuals to become as independent as possible through assessment, support and providing choices. Individual learning plans are used to enable students to achieve their objectives. Florence Villa is a detached, domestic-style property with two bedrooms and an annexe in the grounds. It is a short walk from Longton town centre and a bus ride from other city amenities. Five of the rooms are doubles and the rest are singles. Staff from Florence Villa also supervise and support the students at Hamilton Road. Staffing consists of the manager (who is also the Principal of the college), deputy manager, keyworkers, learner support workers, trainers, behavioural support worker and a part-time psychologist. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. For this unannounced, evening inspection there were two inspectors, Katie Claffey and David Morgan. Inspectors spoke to various members of the staff team including the care manager. A large number of students were also spoken to in detail. One student provided the inspector with a guided tour. Certain records were also inspected. The manager was available to assist the inspectors. The planned arrangements for a new manager will be implemented in the near future. The existing manager is also principal of the college but is overseeing the residential unit whilst the deputy principal oversees education. The majority of students were seen; some were spoken to in passing and a small number in detail. They raised no concerns and said they were happy at the college. Students discussed their activities in particular and were clearly well occupied. Care issues were discussed with the manager in detail, especially those which had led to notifications by the college to the inspectors. The home is registered for up to four service users who are either 16 or 17 years of age, i.e. not adults. Additional standards therefore apply but were not inspected on this occasion. Relevant staff training and other relevant arrangements have been thoroughly discussed previously. Planned changes include improvements to the sleeping arrangements for staff and the possibility of only using waking night staff and not having sleep-in staff at all. A gate may be installed to control access to the site. What the service does well: The home was clean and tidy and the residents were able to express their individuality with their personal belongings in bedrooms. Relationships between staff and residents were positive and appropriate. Students said they liked living at the college and that they felt cared for. Liaison with parents is good. The area manager gave examples of the staff team supporting the families of the students in their goal for independent living. Individual needs are being addressed well. The college routinely reviews and plans activities. This is reflected in the development plan for the year that particularly addressed any areas of weakness. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 6 Appropriate levels of staff and staff training are arranged. Auditing and analysis of trends is a strength of the service. 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 Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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 Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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): EVIDENCE: Not inspected. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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 Students are involved in their plans and are facilitated to make decisions about themselves and the college. EVIDENCE: Service user plans are in place and are up-to-date; a sample was inspected. No concerns arose. The manager reported that the plans would be part of an improved auditing system in future. Students were positive about their care and were familiar with their routines. They are routinely consulted and enabled to make decisions within the parameters of the college curriculum. Free time is routinely available. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 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 the following standard(s): EVIDENCE: Not inspected. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 11 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): 20 Medication is appropriately managed although recommendations were made regarding controlled drugs. EVIDENCE: The inspector reviewed the medicine administration processes with staff. No major concerns arose and there was evidence of good practice. Self-administration was also considered. The skill of students usually improves as they stay at the college and some become more independent (e.g. regarding self medication) than others; this is kept under review by staff. The management of controlled drugs was inspected. This was satisfactory but the inspector recommended that a) storage be reviewed in line with guidance and b) recording be made in a hardbound book. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 12 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 Students are listened to and are helped to obtain relevant support. EVIDENCE: There have been no complaints recently. The regional manager processes complaints. The manager provided evidence to inspectors that advocates and solicitors are obtained for students when necessary. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 13 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 The property was well presented and no major concerns arose. EVIDENCE: Accommodation. An inspector undertook an inspection of the main areas of the home with a student; no major concerns arose (see also Standard 42 below). The home was well presented, clean and tidy. Laundry and food storage areas were satisfactory. The manager was aware of a problem in one bedroom that was causing malodour and appropriate action is required. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 14 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): 33; 36 Appropriate staffing arrangements are in place. Staff training is under review. Supervisions and appraisals are understood to be in place but a record is required to be kept on site. EVIDENCE: Staffing arrangements were discussed with the manager and rota records were inspected. One agency member of night staff is being used and appropriate checks have been completed; support is provided by a permanent member of staff sleeping-in. One new key worker has been employed but otherwise staff turnover has been minimal. Staff training is being reviewed for the next financial year as the manager feels improvements could be made, e.g. to avoid using distance learning. Precise details were not inspected this time although it was found that certain gaps had occurred, especially in respect to Craegmoor’s own guidelines; this will be revisited next time. Supervision records were not available for inspection; this must be addressed. The manager is undertaking all the supervision meetings and appraisals although the new, proposed, manager has created the schedule. This emphasises the need to improve the skills of the senior team so that responsibilities can be delegated. The manager has this in-hand. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 15 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): 38; 39; 42 Students benefit from a well managed home in which appropriate monitoring occurs. Health and safety is promoted but extra attention is needed to nighttime fire safety precautions and also security. EVIDENCE: Management issues are discussed in the previous report. A new manager has been appointed and will be presented to CSCI for registration in due course. The existing manager has identified that the senior team need to increase their range of skills to perform adequately and this is being addressed. There are a variety of auditing tools in place, some of which are internal and others that are applied by the organisation. The manager provides the regional manager with a summary of events, e.g. accidents and safety issues. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 16 On site, however, there is no overview of incidents and this should be reviewed. Fire safety was inspected. Tests and drills occur and are up-to date. Nighttime drills should be considered. This is a sensitive area and will need careful thought but it is also the time of highest risk. Staff must know what action to take at night and whether any students will need special attention. The risk assessment must be reviewed as a consequence. Two safety issues arose. Two students are now using the new bedrooms in the grounds. It has been proposed that they use the kitchenette near the back door which has been largely unused for some time. This is attractive because of the proximity to their rooms but is not suitable because of the safety issues. This was discussed during registration of the rooms and accepted by the previous area manager. Similarly, the use of the kitchenette is not ideal for students in the main house for the same reasons and would have to be carefully risk assessed. Any proposal to use the kitchenette must be subject to a comprehensive risk assessment. The second issue is that the back door is kept unlocked in the evenings. This allows unmonitored access to the main building. This must be reviewed immediately. There was also no doorbell or door closure. Appropriate accident records are kept. Appropriate notifications have been made to CSCI and this has also helped keep inspectors abreast of developments. Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 17 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 X 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 X ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 X STAFFING Standard No Score 31 X 32 X 33 3 34 X 35 X 36 2 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X X X X LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score X X 2 X 3 X 3 X X 2 X Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 18 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. 1 2 3 4 5 Standard YA36 YA42 YA42 YA42 YA24 Regulation 17(2) 23(4) 13(4) 23 23(2) Requirement Evidence is required to be kept on site of staff supervision meetings. The nighttime fire safety procedures and risk assessment must be reviewed and practiced. Any proposal to use the kitchenette must be subject to a satisfactory risk assessment. Access to the property must be made secure. Malodour in one bedroom must be addressed. Timescale for action 01/04/06 01/04/06 01/04/06 01/04/06 01/04/06 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 YA39 YA20 Good Practice Recommendations An overview (log) of incidents should be kept on site. Controlled drug storage should be reviewed in line with guidance and records be made in a hardbound book Florence Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Stafford Office Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 Villa & Independent Unit DS0000008229.V278930.R01.S.doc Version 5.1 Page 20 - 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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