CARE HOME ADULTS 18-65
Furzehill Road (9) 9 Furzehill Road Borehamwood Hertfordshire WD6 2DG Lead Inspector
Julia Bradshaw Unannounced Inspection 10:00 14 November 2005
th Furzehill Road (9) DS0000019392.V285021.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 Furzehill Road (9) DS0000019392.V285021.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. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Furzehill Road (9) Address 9 Furzehill Road Borehamwood Hertfordshire WD6 2DG 0208 953 8401 0208 953 8401 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) Royal Mencap (Housing & Support Services) Daniel Smyth Care Home 6 Category(ies) of Learning disability (6), Learning disability over registration, with number 65 years of age (6) of places Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: 1. The Manager, Mr Daniel Smyth, must gain qualifications equivalent to NVQ 4 in care and management by 2005. 18th February 2005 Date of last inspection Brief Description of the Service: 9 Furzehill Road is an ordinary two storey semi-detached house operated by the voluntary organization Mencap as a six bed care home for adults with learning disabilities, located in Borehamwood just off the high street. All the bedrooms are singles and the home has a variety of communal spaces decorated and furnished in domestic styles. All the town facilities are nearby. There is a bus stop outside the home and a railway station within walking distance. The home is staffed twenty four hours a day and aims to support the service users to lead the lifestyles they choose in a safe environment. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the first unannounced inspection of the inspection year and took place over one day. The majority of time was spent talking to service users, and staff. Some time was also spent in the office looking at Service user Plans, risk assessments, complaints and staff training. Service users and staff were very welcoming. The home is currently without a manager and this situation requires urgent action. This was generally a positive inspection, and the majority of the standards were met. Requirements were made in relation to the environment and staff training. This report has been unavoidably delayed and has been superceded by the recent inspection report conducted on 6th January 2006. What the service does well:
Furzehill Road presents as a warm and welcoming home with clear evidence that service users are involved and consulted in various aspects of running the home. The staff have created a welcoming, comfortable and enhancing environment for the six people who live there. Service user files contained all the relevant information and risk assessments had been updated since the last inspection took place. Health and safety and all COSHH assessments are updated and reviewed annually. All the required policies and procedures were in place including a copy of the statement of purpose and service user guide. The home appeared clean and well cared for. The allocated staffing levels within the home are adequate although there are currently three fulltime vacancies. These arrangements are not ideal as there have been occasions where staff have not turned up from the respective agencies. A range of activities and entertainment are organised by the staff team. Staff members spoken to were very positive about the home and appeared committed to their work. There is plenty of opportunity for staff to progress within their role, training and development is very much encouraged. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Furzehill Road (9) DS0000019392.V285021.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 Furzehill Road (9) DS0000019392.V285021.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): 1,2,3,4 & 5. Prospective service users individual aspirations and needs are assessed and reviewed, enabling the service user and the staff to continuously review the individuals care package provided. Information provided to the service user about the home and its terms is suitable to meet their needs and therefore enables the service user to make an informed choice about where to live. EVIDENCE: A detailed Statement of Purpose is held within the home and all current and prospective service users are provided with a copy. The Statement contains information for the service user to make an informed choice about where to live. The content is suitable to meet individual needs. The Statement of Purpose requires minor amendments. However all these documents could benefit from being adapted into a more “user friendly format” Full assessments of each service users needs and aspiration are made before the service user moves into the home. The assessments carried out are continuously occurring supporting and monitoring individual progress and needs identified. Experienced and competent people complete these assessments. The home also receives and seeks external specialist support to meet the individual service users needs. Whole life reviews occur to support the service users in achieving and reviewing individual needs, goals and
Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 9 aspirations. However the staff are currently in the process of introducing Person Centred Planning into the home. The preliminary documentation inspected looked impressive. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 10 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): 7,9 & 10 Individual needs and choices within the home are being promoted to encourage and empower user self-determination. EVIDENCE: All service users have an individual service user plan and an allocated key worker to support them. Individual daily guidelines/diary notes for service users are maintained. All service users are supported within the Person Centred Planning programme and regular reviews occur to ensure changing needs are continuously assessed and reviewed. The ethos within the home promotes that the care plans of each individual are owned by the individual, those service users spoken to during the inspection were aware of their individual care plans. Each service user is encouraged to take part in daily living tasks, for example being supported with meal preparation, washing up, laying the table, shopping. The staff and the service users have devised a rota, following discussions with the service users this is effective and people appear to enjoy being part of the running of the home. The home is nicely decorated and the service users have made the choices for decoration collectively.
Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 11 All information within the home is handled with care and respect. All personal notes and files detailing information on the service user are locked away. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 12 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): 11,13,16 & 17. Personal development opportunities are encouraged for all service users ensuring interactions within the local community and that individual rights and responsibilities are recognised and supported. EVIDENCE: Three service users attend the Borehamwood day centre, one person attends Balmoral day centre. One service user has a voluntary job at a local Dr Barnando’s charity shop in Borehamwood. Discussions with the service users determined how they plan their leisure activities and staff are there to support people in accessing these opportunities within the local community. Service users appear to have a variety of day activities to be involved within. Access to transport occurs with the use of the home’s onsite transport. Staff support and encourage all service users to maintain and develop social, emotional, communication and independent living skills. All six service users have one day off per week in order to attend to their personal tasks including washing, cleaning their rooms and personal clothes shopping, this is usually combined with a trip out for lunch. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 13 The home is central to Borehamwood High Street and is within a residential area of the town. Routines promote and encourage service user independence. Service uses are unrestricted in movement around the home. Menus are offered on a flexible basis, with service users making choices over the meals daily. The home should be congratulated on providing pictorial information in order for service users to make informed choices regarding the preparation of menu’s and shopping lists. Service users are involved in meal preparation with appropriate support provided. All service users are provided with external nutritional advice and assessments and service users weights are now being carried out monthly and being recorded. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 14 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 All personal and health care support is well maintained within the home ensuring individual needs, choices and preferences are met at all times. EVIDENCE: All care provided is individual and tailored to each person needs with service users choices and preferences being promoted. Assessments and reviews are continuously completed ensuring that the approach adopted is person centred and holistic to each service users needs. Service users needs and are supported with all aspects of their physical and emotional health and receive adequate and appropriate input from specialists such as community nurses, consultants, GP, dentists, opticians and dieticians. Information and advice is provided to all services users regarding general health issues. A comprehensive policy and procedure is in place to support the safe administration, storage and receipt of medicines. All staff receive training prior to being deemed competent to administer medication. A dosette system for dispensing medication is in place. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 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 & 23 The complaints procedure within the home is sufficient and adequate in order for the service users to feel that their individual views are listened too. Robust policies, procedures and training are in place to ensure service users are protected and safe. EVIDENCE: A comprehensive complaints procedure is in place, which details that all complaints are responded to within 28 days. A record is maintained of complaints made detailing actions and outcomes as necessary. The staff should be congratulated in providing this information in pictorial form for all service users who find the written word difficult to interpret. All service users have been informed about the complaints procedure. This is also on display within the home. Robust procedures are in place to ensure that service users are protected from abuse and harm. However there was insufficient evidence seen on the day of the inspection to demonstrate that all staff have received up to date training on adult protection. Staff records were not checked on this occasion, as the deputy manager was not on duty. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 16 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 The home and its surroundings offer a pleasant. The home is clean and well maintained. Two bedroom requires some attention. All bedrooms are personalised offering a homely, lived in feel. Health and Safety must not be compromised by wedging fire doors. EVIDENCE: Two bedrooms are in need of redecoration and two service users require new beds. Fire doors must not be kept open by any other means than those approved by the fire officer. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 17 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): These standards were not inspected on this occasion. EVIDENCE: These standards were not inspected on this occasion. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 18 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): These standards were not inspected on this ocassion. EVIDENCE: These standards were not inspected on this ocassion. Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 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 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score X 3 X 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 2 2 X X X X X LIFESTYLES Standard No Score 11 3 12 X 13 3 14 X 15 X 16 3 17 Standard No 31 32 33 34 35 36 Score X X X X X X CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Furzehill Road (9) Score 3 3 3 X Standard No 37 38 39 40 41 42 43 Score X X X X X X X DS0000019392.V285021.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 2 Standard YA24 YA24 Regulation 23 (2) (d) 23 (4) (c) (iii) Requirement Bedrooms must be decorated and equipped to meet service users needs. Fire doors must not be held open by means other than those approved by the fire officer. Timescale for action 31/03/06 14/11/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Furzehill Road (9) DS0000019392.V285021.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Hertfordshire Area Office Mercury House 1 Broadwater Road Welwyn Garden City Hertfordshire AL7 3BQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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