Inspection on 09/11/05 for Forestview

This inspection was carried out on 9th November 2005.

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 found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Forestview 17/03/09

Forestview 21/03/07

Forestview 09/03/06

Forestview 02/02/05

Forestview 10/11/04

Forestview 10/02/04

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

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

CARE HOME ADULTS 18-65 Forestview 60 Cherry Orchard Marlborough Wiltshire SN8 4AS Lead Inspector Steve Cousins Unannounced Inspection 09:15 9 November 2005 th Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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 Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Forestview Address 60 Cherry Orchard Marlborough Wiltshire SN8 4AS 01672 512464 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) White Horse Care Trust Mrs Allyson Kim Read Care Home 8 Category(ies) of Learning disability (8), Learning disability over registration, with number 65 years of age (2) of places Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. The maximum number of service users that can be accommodated at any one time is 8 No more than 2 service users with a learning disability, aged 65 years and over may be acommodated at any one time The difference in age between the youngest and oldest service users must not exceed 45 years 2nd February 2005 Date of last inspection Brief Description of the Service: Forest View is a spacious bungalow situated in a residential area of Marlborough. The home is registered to provide residential care to eight people who have a learning disability. The home is managed by the White Horse Care Trust and is one of a number of care homes run by the Trust. The house is furnished in relation to service users needs and offers a number of communal areas in the form of a spacious lounge, separate dining room and breakfast area within the kitchen. Service users access various outreach services and day sessions and the home has its own transport. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Service users are known as clients’ at Forestview. This unannounced inspection took place on the 9th November 2005, between 9.15am and 3.00pm. There were eight clients in the home. The findings from this inspection are based on a tour of the premises, speaking to some clients, the manager and staff, and inspecting a number of records, including care plans. The inspector met with Mrs Read, the registered manager, at the end of the inspection to report the findings. Few clients at Forestview are able to fully communicate their views; therefore this report mainly reflects the observations of the inspector based on the findings of the inspection. What the service does well: What has improved since the last inspection? What they could do better: The home is currently providing a good level of care and support. Minor improvements are required in recording staff checks and monitoring hot water temperatures. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 6 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. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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 Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 3 and 5 The home is able to meet the needs of those admitted and individual contracts are supplied. EVIDENCE: The manager stated that there had been no new admissions to the home since the previous inspection. A copy of the homes previous inspection report was on display and service user guide and statement of purpose were available. The findings of this inspection indicate that the home has the capacity to meet the needs of people with profound learning disability and challenging behaviour. The manager and staff appear to have the skills and experience to support the client group to live in a domestic environment and enable them to access community services. Clients plans contained their contracts/terms and conditions of occupancy along with an explanatory booklet using pictures. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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 Clients’ needs are reflected in personal plans. They are supported to make decisions about their lives and to take responsible risks to maintain their lifestyle. EVIDENCE: All clients have comprehensive individual plans that are regularly reviewed. Relevant assessments are completed and there are good, clear explanations of their needs and behavioural traits along with clear guidance on appropriate interventions, if required. All clients have a key worker and the manager demonstrated an excellent awareness of clients individual needs. The information found in clients’ plans, allied to the comments of the manager and staff, indicated that clients’ rights to make decisions are respected wherever possible and they are supported to take responsible risks. Any restrictions on clients are recorded and comprehensive individual assessments were in place to minimize any risks that had been identified. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 13 and 17 Where possible, clients are supported to maintain contact with the community. Clients are offered a healthy diet. EVIDENCE: Adapted transport is available and many clients attend day services in the local community. They have the opportunity, with the support of staff, to go shopping or on outings to local towns and leisure facilities. It is acknowledged that some clients’ behavioural traits inevitably mean they are unable to fully integrate into the community. Meals are prepared by the support staff to generally ‘fit in’ with the clients daily routines. A light meal is provided at midday and a more substantial meal in the evening. Clients are normally offered a choice of up to three dishes, however the manager reported that staff have come to know their individual likes and dislikes. Clients’ are regularly weighed in order to monitor whether they are receiving adequate nutrition and staff supervise those who have swallowing difficulties. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 19 and 20 Clients’ health needs are being met and they are protected by the homes procedures for dealing with medicines. EVIDENCE: There was evidence in clients plans to indicate that their physical and emotional health care needs were being addressed and reviewed, and that advice was sought from healthcare specialists, GP’s and the mental health team as required. The manager reported a good working relationship with the two local GP’s who visit on request and also carry out annual healthy assessments for all the homes clients. Separate files are kept for reporting daily issues for each client and recording visits from GP’s or other healthcare professionals. None of the present clients has the capability to self administer medications. The manager reported that eight out of the current twelve members of staff are trained in medicine administration. Medication administration records were well kept and there are good guidelines regarding the use of PRN medicines. All medicines were securely stored. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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 and 23 Complaints are taken seriously and, as far as possible, clients are protected from abuse, neglect and self-harm. EVIDENCE: A complaints procedure is available in a format accessible to clients. No complaints had been received by the home. A complaint received by CSCI and the local vulnerable adults unit in May 2005 was investigated to a satisfactory conclusion and in a timely manner. Staff indirectly observed interacting with clients were patient and supportive. Clients’ records indicated that some could exhibit aggressive and challenging behaviour. Where this was the case, clear guidelines were in place for managing that behaviour to lessen the risk to others. The manager and the staff spoken to demonstrated an awareness of abuse issues and training is available. Staff Criminal Record Bureau (CRB) checks are undertaken and new staff are checked against the Protection of Vulnerable Adults (POVA) list. An adult protection procedure and whistle blowing policy are available. There were safeguards in place regarding the handling of service users money. Two ‘accounts’ were checked and found to be satisfactory. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 24,25, 27 and 30 The home is clean, safe and suitable to the clients needs. EVIDENCE: The home was in good order, well decorated and very clean, and there were records of routine maintenance. Communal areas are homely and contain comfortable furniture that meets the clients’ needs. There are accessible grounds. Laundry facilities were satisfactory. Bedrooms were individualised and decorated differently, although it is acknowledge that this was not possible in all cases due to the behavioural traits of the clients. There are adequate baths and toilets and a new assisted bath was due to be installed, which should enhance the current facilities. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 33,34,35 and 36 Clients are supported by competent, qualified and effective staff and are protected by the homes recruitment procedure. Staff are well supported and supervised. EVIDENCE: The manager reported that there was a settled staff group in the home and that she was currently hoping to recruit a further support assistant to enhance the level of support to clients during the day. There was normally a minimum of four staff on duty during the day along with a domestic assistant, and two staff at night. Review of a selection of staff files indicated that recruitment practice is satisfactory. For inspection purposes it is recommended that the date staff POVA checks are received be recorded. A comprehensive staff training programme, provided by White Horse Care Trust, is in place, which involves specialised as well as mandatory training. Staff training records are kept. New staff undertake induction training and receive supervision and a review during this period. The inspector spoke with a new member of staff who confirmed this. There is a formal staff supervision structure in place and records indicate that staff receive regular supervision. Regular staff meetings are held. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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): 37,38 and 42. The home is well run for the benefit of the clients’ and their health and safety is generally promoted and protected. EVIDENCE: Communication between all levels of management appears good, and the manager is qualified, experienced and effective. The manager attends White Horse Care Trust management meetings and in house staff meetings are also held and recorded. Staff spoken with indicated that the home was effectively managed and the felt that they were able to ‘have their say’ when required. A representative of the Trust carries out monthly visits to the home. A tour of the building indicated that it was free from health and safety hazards. Monthly audits are carried out which include vehicle safety and a health and safety committee meets every four months. Radiators are covered and the hot water supply is controlled, however regular checks of hot water temperatures were not currently undertaken. The need for this was discussed with the manager. Records indicated that essential equipment and services were Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 16 regularly maintained. The water supply had been checked for Legionella. Generic risk assessments regarding the environment are in place. The fire safety arrangements were satisfactory and there were risk assessments in place, which related to some clients inability to respond to the fire alarm. Fire safety checks were carried out at the required frequency. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score X X 3 X 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 X 3 X Standard No 24 25 26 27 28 29 30 STAFFING Score 3 3 X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score X X 3 3 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Forestview Score X 3 3 X Standard No 37 38 39 40 41 42 43 Score 3 3 X X X 3 X DS0000028676.V253761.R01.S.doc Version 5.0 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 Standard YA42 Regulation 13 (4,a) Requirement The registered person is required to ensure that monthly water temperature checks are carried out at all hot water outlets accessible to service users Timescale for action 01/12/05 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 YA23 Good Practice Recommendations In order to evidence good recruitment practice, it is recommended that the home records the date staff POVA checks are received. Forestview DS0000028676.V253761.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection Chippenham Area Office Avonbridge House Bath Road Chippenham SN15 2BB 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 Forestview DS0000028676.V253761.R01.S.doc Version 5.0 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!