Inspection on 19/06/06 for Floshfield

This inspection was carried out on 19th June 2006.

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

Floshfield 21/02/06

Floshfield 13/07/05

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 Liz Kelley Unannounced Inspection 19th June 2006 09:00 Floshfield DS0000022553.V291985.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 Floshfield DS0000022553.V291985.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. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Floshfield Address Cleator Moor Cumbria CA23 3DT 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) 01946 810987 West House Miss Doreen Holding Care Home 6 Category(ies) of Learning disability (6) registration, with number of places Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 21st February 2006 Date of last inspection 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. All referrals are arranged through Social Services. The current scale for charging is £563.32. A Handbook is available for prospective residents, which includes a summary of the latest Commission for Social Care Inspection report. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an inspection were all the key standards were examined and included a visit to the home. A partial tour of the premises was undertaken, as some bedrooms were locked and the occupants were not at home to seek permission to enter. Staff, resident’s records and administration files were examined. Two members of staff were on duty and assisted with the inspection. Three residents were at home and spoken to and time was spent with them in the home. Feedback cards had been received from residents, relatives and professionals. What the service does well: 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 Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 6 contacting your local CSCI office. Floshfield DS0000022553.V291985.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 Floshfield DS0000022553.V291985.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The Home has robust and well-established procedures in place to introduce new residents. EVIDENCE: The home has a Statement of Purpose and a Service User Guide. Both are well presented and contain a lot of information about the home and about Westhouse. These documents set out that the home’s ethos and demonstrates that staff individually and collectively have the skills and experience to deliver the services and care the home offers to provide. These should assist any prospective service user to make a decision about whether to live there. Westhouse’s admission procedure requires a full assessment of need to be undertaken for new service users. Floshfield has not had any new admissions for many years. All the case files examined had full assessments of health and care needs and risk assessments. These are reviewed regularly and updated. The home has made good progress in developing its person centred planning process. These plans contain information about service users’ aspirations and desires in life as well as their needs. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 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,and 9 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff work hard to encourage residents to take control and make informed choices which is carefully monitored through a well-developed system of care planning. Risk taking is well-managed and a good balance is achieved between promoting independence and ensuring well-being and safety of residents. EVIDENCE: Care Plans and risk assessments are developed to a high standard which ensures that: residents needs are met; individual life-styles promoted; and decision making and choice encouraged. Files are well-organised and a good deal of cross-referencing is carried out to ensure that staff are informed and fully up-to-date on important information. This is backed up with clear policy and procedural guidance such as “ Arrangements for Monitoring Progress and reviewing the Care Plan”. Care plans were set up for daily/monthly/yearly needs and these were reviewed monthly and this ensured that these documents were an active tool that was carefully tailored to the individuals needs. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 10 Residents assessed needs are in good detail and clearly expressed in care plans. Residents are empowered to be involved in setting goals while also making them aware of risks involved. This has led to the home achieving a good balance between resident’s rights and their duty of care in ensuring wellbeing and safety. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 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 the following standard(s): All the above standards Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s rights are promoted and each person has a good degree of control and choice. The meals in the home are of a good quality offering both choice and variety, and cater for special dietary needs. Staff are committed to supporting residents to lead interesting lives engaging in different leisure activities, individual hobbies and interests. EVIDENCE: Residents are assisted to have a good quality of life and access to a variety of life experiences through a skilled and committed staff team. Residents were supported to maintain and develop relationships with the community. Good supportive relationships have been developed with neighbours, one of whom visits the home every Sunday to support residents who wish to follow their religion. Interaction between staff and residents was observed to be positive, relaxed and of a warm nature. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 12 Menus are planned with residents on a weekly basis and a communal evening meal is encouraged. Although there is a weekly big shop for the house where residents choose to take part, individual shopping is also encouraged to develop independence and daily living skills. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 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 the following standard(s): 18,19,20 and 21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good systems have been developed to monitor individual’s health and medication. Established links with local health care professionals ensure residents receive effective and timely health care. The home has sensitively handled the ageing process and offered good support to minimise any impact on independence. EVIDENCE: The home has recently identified ageing issues for residents and has looked at a number of solutions to minimise any negative impacts on residents. For example the home has sought the expert advice of an Occupational Therapist and adaptations have been recommended. Staff have a good understanding of residents healthcare needs. The staff team work positively with local health care professionals to offer a responsive and supportive approach in assisting people to maintain good health. Records on healthcare needs are well maintained and kept up-to-date, these are linked to care plans to alert staff on any changes, and include monitoring sheets for specific issues. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 14 The home works to an efficient Medication Policy supported by procedures and practice guidelines. Staff follow robust systems to make sure that medication records are fully completed, contain required entries and are signed by appropriate staff. Staff have received basic awareness training and have all recently enrolled on Medication training to NVQ2 level. This is good practice and will ensure safe standards are met. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 15 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 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff have good knowledge and understanding of Adult Protection issues which protects residents from abuse. The home has a satisfactory complaints system with residents being able to express their views on the home, and these are acted upon. EVIDENCE: The Home has induction training that covers adult protection issues and the various forms of adult abuse. Residents had good and varied links with outside organisations and advocate groups which ensured that they had channels to express views and concerns if necessary. Staff have received training in the use of physical intervention procedures, which focused on diversion tactics rather than physical restraints, these are not used. Staff were encouraged to look for triggers and distraction measures and only when these failed was medication used to calm people down. This PRN medication had been agreed and reviewed by the residents medical Consultant. The home had polices and practices that safe guarded the handling of residents monies. Personal monies and records were examined and found to be correct, with the signatures of both staff and the resident. These areas, and training in Adult Protection safeguarded residents from abuse. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 16 Residents were observed freely expressing opinions to staff. Residents said that they would feel able to speak to any of the staff and approach the manager with any issues they had. Those residents spoken to said they would approach the manager with any issues and felt confident that any concerns would be sorted out. Floshfield DS0000022553.V291985.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s benefit from living in a well kept and safely maintained home that is centrally located for local amenities. EVIDENCE: The home provides good quality accommodation that is homely, safe and clean. This is greatly assist by the clear lines of accountability and management of the home, as each staff has a designated area, for example for Health and Safety management, Infection control, Fire precautions. The home has a clear housework rota, and all these measures ensure a clean, hygienic and safe environment. Individuals bedrooms are particularly impressive being large, well decorated and individual in style reflecting each residents tastes and interests. Satisfactory reports had been received from both the Fire Officer and the Environmental Health officer. Floshfield DS0000022553.V291985.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34,33, 36 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staff are well-trained and supported to have the skills to support people with a learning disability. The recruitment practices of the organisation and the home ensure that residents are safeguarded and that staff have the qualities and aptitudes to work in social care. EVIDENCE: The numbers of staff on duty have recently been improved and this has allowed more opportunities for residents to go out or to spend more time with staff doing individual activities. This is a positive development and with the increased use of Person centred plans this will lead to more individualised lifestyles and increased choice for residents. West House commitment to training is demonstrated by its comprehensive programme of ongoing training and NVQ at all levels. All staff in the home have received training to at least NVQ level 2, and some have progressed to level 3. These levels exceed the expected minimum requirements of 50 . The Home follows the recruitment procedure of West House, the organisation that runs the home. Staff files are now held in the home, contain all the relevant documentation and are clearly sectioned and well organised. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 19 The selection procedure included obtaining two written references, a formal interview and an informal interview involving service users, wherever possible. All staff had CRB disclosure checks. Upon appointment staff were issued with a handbook, which includes job descriptions and terms and conditions. Appointments are subject to a six-month probationary period. West House has a code of conduct and all members of staff have a statement of terms and conditions. These are all good practices and ensure that residents are supported by a carefully selected and vetted staff team. Floshfield DS0000022553.V291985.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39,42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The new manager has gained the confidence of the staff and was providing good leadership to a strong, established team who together, were well equipped to meet the needs of individuals. The home benefits from regular reviews. EVIDENCE: The home benefits from regular reviews set out by West House, of its performance through a good programme of self-review and consultations, which include seeking the views of residents, staff and relatives. A Quality Assurance system ensures that residents views are listened to and acted upon. From information gained from residents, staff and from documentary evidence the manager was judged to be competent and effective in managing the Home. The home has an Action Plan for Service Delivery, which acts as a self-audit of quality. Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 21 The administrative systems within the home were found to be up-to-date and in good order, ensuring the home was run in an efficient and effective manner. Fire Records, annual gas and electrical checks, and servicing of hoists were all checked and these were all up-to-date. Risk assessments and Health & Safety policies and procedures have been reviewed ensuring that staff had the latest guidance. Floshfield DS0000022553.V291985.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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 4 33 3 34 3 35 X 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 3 3 X 3 X X 3 X Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Floshfield DS0000022553.V291985.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria 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. 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