Inspection on 08/09/05 for Foxdown

This inspection was carried out on 8th September 2005.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Foxdown 19/02/08

Foxdown 23/02/07

Foxdown 23/02/06

Foxdown 08/03/05

Foxdown 04/11/04

Foxdown 02/03/04

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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 FOXDOWN Paley Street Nr Maidenhead Berkshire SL6 36N Lead Inspector Amanda Longman Unannounced 8 September 2005 10:00 th 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. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Foxdown Address Paley Street Nr Maidenhead Berkshire SL6 36N 01628 776507 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) Owl Housing Limited Ms Joy Gardiner Care Home - Private Care PC 6 Category(ies) of Learning Disability (LD) registration, with number 6 both sexes of places FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 8th March 2005 Brief Description of the Service: Foxdown is a 6-bed bungalow situated in a quiet location in Paley Street near Maidenhead. The home caters for the needs of people with learning and associated physical disabilities some of whom may display challenging behaviours. The aims and objectives of the home are to provide 24-hour care and support, promoting equality and independence in accordance with the individual’s needs and aspirations FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Foxdown is owned by Owl Housing. It has been home to the same group of six service users since its opening in 1999. This was an unannounced inspection which began at 11.00am. The inspector was welcomed by the deputy manager. The manager was not on duty at the home. Four service users were out with the shift leader and another member of staff, but returned during the course of the inspection. Two service users were relaxing at home, one of whom was watching television. This was a positive inspection with only two requirements. The home has a happy, homely atmosphere and benefits from good facilities. Service users’ rooms are large, comfortable and individually furnished and decorated. Service users benefit from well structured care plans and are supported by trained and caring staff. A new manager has recently been appointed and the home is developing well under his leadership. To complete the inspection the inspector spent several hours at the home. Three staff were spoken with, one of whom, the shift leader, was spoken with in depth. Two service user files were examined in detail, as were policies and procedures and training records. None of the service users were able to communicate in depth with the inspector but interactions between staff and service users were observed. What the service does well: What has improved since the last inspection? All but one of the requirements and recommendations made in the previous inspection report have been met. A new manager is in post who is supporting his staff to further develop the care offered. This included taking one service user on holiday to his choice of destination – Istanbul. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 6 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. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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 FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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) 1, 2 and 5 Prospective service users would have the information they require to make an informed choice about where to live and their aspirations and needs would be assessed. Service users have individual contracts with the home and access to a statement of terms and conditions. EVIDENCE: Evidence from a discussion with the shift leader and service user files show that Foxdown has not had any vacancies since it opened in 1999. However, the current Statement of Purpose and Service User Guide provide the required information to assist a prospective service user to make an informed choice. Service user files show initial full assessments were undertaken with each service user and that these have been regularly reviewed with relevant input from appropriate professionals (including care managers, psychiatrists and day care staff), leading to up to date care plans which encompass the needs and aspirations of the individual. Up to date accommodation agreements and terms and conditions were seen on service user files. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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 and 9 Changing needs and personal goals are thoroughly reflected in support guidelines for each service user which includes information on their personal preferences relating to all aspects of their care, preferred routines and social and family contacts. Good progress has been made by the home recently in supporting some service users to re-establish or develop family relationships. Service users are supported to take risks as part of an independent lifestyle but the home needs to make it clear that when a care plan is reviewed all aspects of it have been reviewed and updated, even if the situation is one of “no change”. EVIDENCE: Examination of service user files showed them to contain detailed information regarding the aims and objectives of care, communication needs, preferred routines for personal care, day care and leisure interests, financial needs and management, identified risks for all activities and a management plan for these risks, decision making and offering choices, and preferences for socialisation and maintaining links with important people. Evidence from talking with the shift leader and looking at records, including photographs, showed a recent garden party which had included service users’ families and friends. The shift leader also provided information about one FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 10 service user who, assisted by staff, has now established regular contact with family members after many years of no contact. A further service user has recently been enabled and supported to choose and enjoy a holiday in Istanbul. Evidence from service user files showed detailed risk assessments describing all identified risks and strategies for managing these, together with a scored system of risk assessment. Although the care plans examined had been reviewed in November 2004 and June 2005 the individual dates on the risk assessment records were June 2002 (description) and February 2004 (scored assessment) for one service user, and August 2003(scored assessment) and February 2004(description) for the second service user. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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) 17 Service users are offered and encouraged to eat a healthy diet and appear to enjoy their meals and meal times and the associated shopping trips. EVIDENCE: The shift leader explained that menus are planned 2 to 3 weeks ahead. Two of the service users regularly go with staff to do the shopping. The main meal is cooked in the evening and records were seen of planned menus and what each service user had to eat. Conversations with staff revealed they know the likes and dislikes and dietary requirements of service users very well and adjust the elements of the main meal accordingly. Care plans were seen to contain weight charts and eating plans as appropriate. They are also very aware of any behavioural needs of service users relating to food and eating. All staff have up to date food hygiene training. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 12 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 and 20 Service users receive personal support in the way they prefer and require. No service users are responsible for their own medication, but they are protected by the home’s policy and procedures relating to medication. EVIDENCE: Service user files contain full support guidelines which cover needs, likes and dislikes relating to their preferred morning routine, bathing support and mealtime support. These guidelines are specific and include information regarding, for example, knocking on doors. They also contain information relating to health care needs, night support and the service users preferred means of communication. All service users have an allocated key worker and these guidelines are reviewed with the service user and their key worker who signs the guidelines. All service users have relatives or advocates who are invited to reviews. The organisation has a policy on Intimate and Personal Care. However, although the policy list stated this was reviewed by Owl Housing in July 2004, the policy on the file was dated April 2001. Discussions with one care worker and the shift leader revealed appropriate knowledge regarding maintaining service users’ dignity and privacy. The medication policy was reviewed and seen to be appropriate. However the policy file states it was due for review in July 2004. Medication is stored and FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 13 recorded appropriately and evidence was seen that all staff responsible for medication have received up to date appropriate training. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 14 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 22 Service users views are listened to and acted upon. EVIDENCE: Foxdown has an appropriate complaints procedure which is presented in a suitable format for service users. The service user files sampled and the interview with the shift leader confirmed that all service users have relatives or advocates to assist them. Care plans for service users provided information as to each service users preferred form of communication and how to present choices and questions to service users. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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 and 27 Service users live in a homely, comfortable and safe environment with appropriate toilets and bathrooms which provide sufficient privacy and meet individual needs. EVIDENCE: The home is a spacious detached bungalow set in a large garden. All six bedrooms are large and single. They are pleasantly decorated and where redecoration has occurred staff explained that service users are encouraged to be involved in choices regarding colours, styles and furniture. The home has a large, comfortable, bright, lounge which is furnished in domestic style and a well equipped kitchen dining room. The home appeared suitably heated and ventilated and records of safety checks and routine maintenance were seen to be up to date and appropriate. There are two bathrooms. One is adapted for wheelchair use and has a bath with a hoist. This is shared by two service users. The second bathroom, also large, is shared by the other service users. It has a bath, separate shower, toilet and basin. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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 and 34 These standards have only been reviewed in relation to requirements made at the last inspection. Service users are supported by an effective staff team and, whilst they are protected by the home’s recruitment policy, its practices are not fully in line with the relevant regulations. EVIDENCE: Following a requirement in the previous inspection report the home reviewed its night time staffing levels and is satisfied it has an appropriate level of night time care staff. A copy of this review was seen by the inspector. Foxdown is owned by Owl Housing and they have an appropriate recruitment policy in place to ensure all relevant checks regarding potential new staff are undertaken. However documents relating to recruited workers are not available for inspection at the home as they are held at Owl’s head office. Full compliance with this standard can therefore not be checked. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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, 40, 41 and 42 Service users do benefit from a well run home. However some policies and procedures are over due for review and some record keeping on service user files requires updating. EVIDENCE: Standard 37 has only been reviewed in relation to requirements made in the last inspection. Standard 42 has only been referred to in relation to a recommendation made in the last inspection report. The standard has not been assessed at this inspection. A new manger has been appointed to run Foxdown who is suitably. He has begun the registration process with CSCI and has commenced NVQ level 4 in Care and Management. The home has extensive policies and procedures covering relevant subjects however some policy documents have passed their review dates. In conversation with staff it became evident that in some cases a newer policy document had been produced but had not yet been filed. The manager is FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 18 therefore required to review that all appropriate policy documents are in place and up to date, and that staff are familiar with the correct version of each policy and related procedure. Record keeping in the home was generally seen to be of a high standard. Regulation 37 notifications are now routinely sent to CSCI as required in the last inspection report. However some records on service user files, for example those relating to risk assessments, had not been updated when the care plan was reviewed. A previous recommendation to secure or remove loose rugs has been actioned. FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 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 3 3 x x 3 Standard No 22 23 ENVIRONMENT Score 3 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score 3 3 x 3 x Score Standard No 24 25 26 27 28 29 30 STAFFING Score 3 x x 3 x x x Standard No 11 12 13 14 15 16 17 x x x x x x 3 Standard No 31 32 33 34 35 36 Score x x 3 1 x x CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 FOXDOWN Score 3 x 3 x Standard No 37 38 39 40 41 42 43 Score 3 x x 2 2 x x H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 34 Regulation 19 Requirement The responsible individual must ensure that staff files held at Foxdown contain the information required by Schedule 2 and are made available to the inspector to check compliance with the standard. This requirement is outstanding from the previous two inspection reports The manager must ensure that all records held in line with Schedules 3 and 4 are updated regularly xxxxxxxx Timescale for action 10.11.2005 2. 41 17 10.12.2005 3. xxxxxx xxxxx xxxxx 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 40 Good Practice Recommendations It is recommended that all policies and procedures, in line with Appendix 2 of The National Minimum Standards for Adults (18 to 65), are regularly reviewed and updated FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 21 Commission for Social Care Inspection 2nd Floor 1015 Arlington Business Park Theale Berkshire RG7 4SA 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 FOXDOWN H52-H01 S47598 Foxdown V236027 080905 Stage 4.doc Version 1.40 Page 22 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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