Inspection on 13/07/05 for Floshfield

This inspection was carried out on 13th July 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 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

Floshfield 19/06/06

Floshfield 21/02/06

Floshfield 28/10/04

Floshfield 16/06/04

Similar services:

Clover House

Parkside

Park Lodge

Mere Hall View

St Bonaventures

Hudson Road

Whitewalls

Home Farm

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

CARE HOME ADULTS 18-65 Floshfield Cleator Moor Cumbria CA23 3DT Lead Inspector Gordon Chivers Unannounced 13 July 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. Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Floshfield Address Cleaton Moor Cumbria CA23 3DT 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) 01946 810987 West House Vacant Care Home 6 Category(ies) of Learning disability registration, with number of places Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28 October 2004 Brief Description of the Service: West House provide the service and care at Floshfield, a home for six people who have a learning disability. The home is a dormer style bungalow set back off the main Cockermouth to Egremont road, next to the Ennerdale Country House Hotel. Floshfield is close to the centre of Cleator and blends naturally into the surrounding area. Accommodation is comprised of kitchen, lounge and dining room on the ground floor. Sufficient bathing, shower and toilet facilities can be accessed on both the ground and upper floors. Single occupancy bedrooms are provided on both floors, with the office and staff accommodation on the first floor.Car parking facilities are available to the front of the home and garden areas are to the front and rear of the building. Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection, commencing at 09.30 and lasting six hours. The inspection took place in the presence of the Acting Manager, Doreen Holding, and included interviews with one of the service users and two members of staff. The inspection focused upon the standard which drew forth a recommendation, and those standards which were not assessed, by the last inspection. The inspector would like to thank the service users and staff of Floshfields for their welcome and cooperation during this inspection. What the service does well: What has improved since the last inspection? What they could do better: The care management system as a whole could be rationalised and better coordinated. Actions prescribed to meet assessed needs should be fully recorded and their effectiveness reviewed. Care plans can then be continued or amended accordingly. Key aspects of practice needs to be regularly reviewed and training updated when necessary. Please contact the provider for advice of actions taken in response to this Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 6 inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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 Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 4 There is an admissions procedure which informs and supports prospective service users in deciding whether to move into the home. EVIDENCE: The home has not admitted a new service user in all of the twelve years that it has been open, although the Acting Manager has had experience of the admissions process whilst working in another home. The home has the appropriate procedure in place with references to a staggered introduction, sensitivity to existing service users, initial assessments and relevant information to guide and inform decision making. The home also has a Service User Guide to inform prospective service users of the terms and conditions of residency. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 6,7,8,9 The assessed and personal goals of the service users are reflected in their care plans. They are consulted on a range of personal and domestic issues; they are supported in making choices and decisions and in taking acceptable risks in undertaking activities. EVIDENCE: The home has full assessments of need, person-centred plans and care plans in respect of all the service users. All of these are reviewed periodically, and there is evidence that the service users participate in these processes. However, there is little cohesiveness about the care management system as a whole. Assessment of need, plan, action and review are not always coordinated and so it is difficult to case track the process. Moreover, reviews appear to be undertaken in an uncoordinated way, rather than all the different aspects being collated every six months into a ‘whole-person’ review. The home has a code of conduct (Guidelines on Professional Behaviour) which emphasis the importance of supporting service users to make their own choices and decisions as far as they are able to. The case files provide examples of these principles being applied and put into action. As well as participation in care planning and reviews, service users are consulted individually and collectively upon a range of domestic and personal Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 10 issues such as menu planning, holidays, leisure pursuits, décor and furnishings, clothes. The home holds service users’ meetings periodically. Full risk assessments are in place in respect of all the service users. These are coupled with risk management strategies and control measures. There is evidence of these being reviewed. The Acting Manager gave interesting examples about how some preconceptions about service user abilities/limitations stemming from the risk assessments had been positively challenged with the result that service users are now able to engage in a wider range of activities about which they had expressed an interest or desire. The service users involved have gained in confidence from these positive experiences with the result that further challenges can realistically be considered. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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 The service users take part in a range of activities of their choice, they are visible in the local community and they have contact with their families and friends. EVIDENCE: The recommendation made by the last inspection that an Activities Organiser be appointed was implemented in February, 2005. Unfortunately the service had to terminate the employment of that post-holder in April, and the post has been re-advertised but remains unfilled. Currently a part-time support worker is deployed for fifty hours per month as unofficial activities organiser, but this is very much a ‘stop-gap’ arrangement. The Acting Manager is aware that this situation requires resolution. Nevertheless, service users continue to undertake a range of activities such as discos, dedicated clubs, hiking, ten-pin bowling, pottery and art work, the cinema. The service users are supported to go into the town of Cleator Moor to shop, bank, have their hair done and have bar meals. They also go to Whitehaven for other social functions. They all attend a communion service which is held in the large vestibule of the home. Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 12 All of the service users have contact with their families to varying degrees and frequencies. Some actually spend weekends with their families on a regular basis. Most families visit the home occasionally. None of the service users have any friends from outside of the home. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 18,19,20 The service users receive appropriate personal care and support, their emotional and physical health needs are met, and their medication is administered appropriately by staff. EVIDENCE: All the service users bath and toilet themselves. They will request support if and when they feel they need it. The staff are prepared to take acceptable risks to enable service users to act independently and exercise their preferences in other respects. The home has comprehensive health assessments on the service users. The case files contain evidence of referral to and contact with health care professionals. Over time staff are able to recognise when any of the service users are upset or distressed, and are able to help them to articulate their concerns and provide reassurance. None of the service users are able to manage their own medication independently. Staff receive refresher training from Boots Pharmacy in the administration of medication every six months. The home has the appropriate policies and procedures for the administration of medication. The medication is stored correctly and the MAR sheets have been completed correctly. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 23 The procedures to protect the service users are in place, but staff do not appear to have had any relevant training. EVIDENCE: The home has the relevant ‘Whistle-blowing’ and Mistreatment of Adults policies and procedures in place. Records of the required CRB checks on the staff in the home were received at CSCI on 18 July. There are no records of the staff having been given training in the protection of vulnerable adults. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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 The home is homely, comfortable and safe. EVIDENCE: The home is well decorated and well furnished. It is spacious, well kept and clean without any unpleasant odours. Each service user has their own bedroom and there are sufficient bathing and toilet facilities. Fire extinguishers, smoke alarms and emergency lighting are in place. The radiators in the bedrooms have no guards around them and the Acting Manager must ensure that relevant risk assessments are in place. The dining room floor needs replacing. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 33 The staff team are effective in their provision of care and support to the service users, but they are temporarily dependent on bank staff to make up all the shifts, and there are gaps in the some training checklist. EVIDENCE: Staff morale has improved markedly since the last inspection as a result of the stability created by the appointment of the Acting Manager. The staff interviewed confirmed this to be the case and also stated that the staff team worked well together and were mutually supportive. The staffing complement for the home is currently 78 hours per month less than required, and this shortfall is made up by bank staff and existing staff working extra shifts. This situation can only be seen as a short-term remedy. The home maintains records of staff training. These include the mandatory annual refresher training in a range of health and safety issues. However, it is also evident that there are some aspects of the work for which staff have not received any or any recent training. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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) 37,41,42 The home is well run, confidential information is stored appropriately, and equipment and infrastructure is tested and maintained to ensure safety. EVIDENCE: The Acting Manager, Doreen Holding, has been in post since October, 2004. She has had previous experience working with people with learning disabilities. Her current probationary period ends in October, 2005. She has applied to CSCI for registration, and is currently undertaking the NVQ level 4 training in management which she expects to complete by Christmas, 2005. The staff interviewed considered her to be approachable, fair and inclusive, and to have made a positive contribution to the running of the home. All confidential information in respect of the service users and staff is kept in a locked cabinet in the office. The home’s environment is comprehensively covered by a series of risk assessments which are regularly reviewed. There is also an emergency plan in place, as well as records of in-house tests by staff in respect of legionella, water temperatures, fire equipment and fire drills. External contractors are Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 18 engaged to check and maintain the electrical wiring, the bath hoists, and other infrastructure. Floshfield F58 F10 s22553 floshfield v234624 130705 ui 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 x x 3 x Standard No 22 23 ENVIRONMENT Score x 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 2 3 3 4 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 2 x x x x x x Standard No 11 12 13 14 15 16 17 x 2 3 x 3 x x Standard No 31 32 33 34 35 36 Score x x 2 x x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Floshfield Score 3 3 3 x Standard No 37 38 39 40 41 42 43 Score 2 x x x 3 3 x F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 20 no 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 12 Regulation 18 Requirement The registered provider must arrange for the post of Activities Organiser be filled, either by a single post holder or on ajobshare basis. The registered provider must arrange for all staff to receive training on the protection of vulnerable adults. The dining room floor must be replaced. Risk assessments in respect of the unguarded radiators in the bedrooms must be undertaken. The registered person must recruit additional permanent staffing to make up the current shortfall. The registered person must make arrangements for staff to be fully trained. Timescale for action 30/9/2005 2. 3. 23 18 31/10/200 5 31/10/200 5 31/8/2005 30/9/2005 4. 5. 6. 24 24 33 23 23 19 7. 33 18 31/10/200 5 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Floshfield Refer to Good Practice Recommendations F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 21 1. Standard 6 The care management process should be better organised so that there is a clear and evident relationship between assessed needs, care plan objective, action and review. All aspects of the review should be collated into a whole pwerson review every six months. Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith CA11 9BP 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 Floshfield F58 F10 s22553 floshfield v234624 130705 ui stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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