Inspection on 15/06/06 for Furzehill Road (9)

This inspection was carried out on 15th 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 found there to be outstanding requirements from the previous inspection report. These are things the inspector asked to be changed, but found they had not done. The inspector also made 4 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Furzehill Road (9) 04/06/07

Furzehill Road (9) 06/01/06

Furzehill Road (9) 14/11/05

Furzehill Road (9) 18/02/05

Furzehill Road (9) 10/05/04

Furzehill Road (9) 14/02/04

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

CARE HOME ADULTS 18-65 Furzehill Road (9) 9 Furzehill Road Borehamwood Hertfordshire WD6 2DG Lead Inspector June Humphreys Key Unannounced Inspection 15&27th June 2006 11:00 Furzehill Road (9) DS0000019392.V300227.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 Furzehill Road (9) DS0000019392.V300227.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. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 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) www.mencap.org.uk Royal Mencap Society No manager presently registered 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.V300227.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: None Date of last inspection 6th January 2006 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.V300227.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the first inspection of this inspection year (April 2006/2007), which was carried out over a period of two afternoons. There were many positive aspects to the inspection. The information in this report is based on: • Two site visits to the home. • Discussions with five out of six service users. • Evaluation of service user questionnaires • Monthly provider reports and telephone contacts with the home since the last inspection in January 2006. The service users appeared pleased and satisfied with the current service. On both visits service users were seen to be happy and well cared for by staff who appear committed and supportive. The service would benefit from a registered manager to continue with the work already started by the current acting manager. What the service does well: What has improved since the last inspection? Service users are supported to take risks as part of an independent lifestyle. A new risk assessment format has been developed which enables service users to understand any concerns that the staff may have. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 6 Obsolete information has now been archived to improve file accessibility as requested at the last inspection. A new care plan format has been introduced (four corners) which once up and running will endeavour to provide greater consistency. Since the last inspection care staff have been recruited, including bank staff to cover for training and annual leave. Difficulties in providing cover, which was seen at the last inspection, should therefore no longer be such an issue. 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.V300227.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 Furzehill Road (9) DS0000019392.V300227.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 Prospective Service users aspirations and needs are clearly identified through the assessment process prior to admission. The quality in this outcome group is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: Prospective service users are assessed prior to admission, and given every opportunity to try the service. Several initial contracts were looked at, and both were individualised, and user friendly. Staff make an effort to assist the service user to understand the terms and conditions of his/her tenancy as part of their induction into the home. The last new admission into the home was in April 2004. Furzehill Road (9) DS0000019392.V300227.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. Care plans were of a variable standard, despite the same format being used. Service users individual needs are being met, and most care plans were regularly reviewed. Service users are supported to take risks as part of an independent lifestyle. A new risk assessment format has been developed which enables service users to understand any concerns that the staff may have. The quality in this outcome group is adequate; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: Four service users files were looked at as part of the inspection. The same format is used with all service users; however the range and quality of information is variable. Obsolete information has now been archived to improve file accessibility as requested at the last inspection, and in most cases the care plans seen had now been updated as required, but continued not to be as frequently (monthly) as stated in the homes policy. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 10 The acting manager showed good examples of person centred plans providing evidence that the service is making good progress in producing written documentation of a good standard. Risk assessments were on file where a particular concern had been raised. The format had been updated and included pictorials. By involving service users, risks could often be minimised allowing the chosen activity to go ahead. The inspector spoke to five out of the six service users as well as looking at daily records. Once again the service demonstrated a real commitment to involve service users in the decision making process, with the opportunity to make real choices about the home and their lifestyle. A person was observed preparing and cooking dinner. The meal had been simplified to enable the person to undertake the majority of the cooking, and was delighted when the other service users said the food was nice. Residents meetings are held regularly, and many of the decisions, such as where to go out for the evening or go on holiday are part of the discussions. The manager said that service users have further opportunity to talk to their key worker, should they not feel able to talk in the larger group. Furzehill Road (9) DS0000019392.V300227.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): 12,13,15,16 and 17 Service users are provided with the necessary support to maintain links with family and friends. Staff actively encouraged service users to participate in community-based activities, which are of interest. Personal development opportunities are seen as a priority and all service users have a varied weekly programme of appropriate social, leisure and educational activities within the community, as well as a range of varied activities provided by the staff in the home. Service users are involved in selecting the food they wish to eat; and staff support by providing information relating to varied, healthy eating. The quality in this outcome group is excellent; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: All service users were out on the day of inspection. One service user returned from having lunch out, it was her day off and she explained that she was involved in a variety of community based activities including work experience Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 12 in a charity shop the remainder of the week. The service user acknowledged that she had changed her timetable a number of times as she ‘got bored with doing the same thing’. Staff confirmed that they had worked hard to try to involve her in activities that she really had an interest in, and that at times this had been a challenge. A second visit to the home in the early evening provided an opportunity to meet with all the service users; there was a nice atmosphere with plenty of positive examples of good communication occurring between staff and service users. Visitors are welcomed into the home, and service users family and friends details were clearly indicated on the file; contacts were recorded. Risk assessments for individual activities had been completed and were kept on individual’s files. This was an example of good practice creating the opportunity for service users to make choices and real decisions about their lifestyle, whilst confident that staff were available to support them if and when necessary. Staff and service users are jointly involved in the preparation of food. Dependent on the choice of the day and how complicated it is to cook meant how much support staff provided. Menus were often adapted to accommodate service users skills. Some frozen foods were used but the majority of food was freshly cooked; this was a very positive system allowing everyone to do as much or as little as they were able. Furzehill Road (9) DS0000019392.V300227.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 and 20 Support is offered to service users in a discreet and sensitive manner, whilst encouraging individuals to maximise their independence. Medication is administered appropriately. Information relating to ageing, illness and death of a service user is limited but adequate to allow individual wishes to be respected. The quality in this outcome group is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: The amount of care, and level of support is dependent on individual need with choice and preferences being noted in the care plan. Whilst the care observed appeared appropriate with staff responding in a professional manner, in some cases care plans were limited in the information provided. When speaking to staff they appeared knowledgeable about the preferences of the people they were supporting and the inspecting officers hypothesis is that overall care is of a good standard as verbal communication is good between the staff team. This is however not a substitute for the written form. Specialist services are available such as community nurses, consultants, GP, dentists, opticians and dieticians. On the day of inspection a dietician visited Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 14 who is providing support and guidance with regard to service users weight. She visits every 3 months. Medication for two service users was checked and found to well stored and appropriately recorded. Service users care plans include only a brief statement regarding the individual preferences relating to death and dying. This has been difficult to discuss with parents/carers, but in some cases staff have worked hard in gathering sufficient information. Furzehill Road (9) DS0000019392.V300227.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 Service users are listened to, and every effort is made to ensure they are protected from abuse. Financial records checked during the inspection were accurate. The quality in this outcome group is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: Regular residents meetings are held and service users are encouraged to view their opinions and any concerns. Several service users were asked if they knew how to complain and both said they would tell ‘Susie’ the manager or their key worker. The Mencap complaints procedure contains sufficient detail to understand how to complain and is available in pictorial format to assist service users in understanding the process. A copy was on display in the home. The acting manager was able to discuss how the service dealt with complaints i.e. the necessity to record information, timescales to respond, and reporting when necessary to CSCI. Staff appeared to have sufficient basic knowledge to enable them to respond appropriately to allegations or suspicions of abuse. Both care workers interviewed were relatively new and had covered the procedure, as part of induction, which the acting manager stated, was good course covering all mandatory areas of training. A random sample of service users financial records were checked during the inspection were found to be accurate. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 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): 24,28 and 30 The home is an ordinary two-storey house located near to the high Street in Borehamwood, providing good access to social and leisure opportunities. The inside of the home is comfortable and homely with a few minor requirements. The garden to the rear of the property requires attention. The quality in this outcome group is adequate; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: The home was found to be clean and odour free on the day of inspection. A few minor requirements were discussed with the acting manager, which included the replacement of the downstairs toilet seat, and the fan and light in the kitchen being cleaned, and working effectively. There is good access to the garden, with a ramp leading from the lounge. The top of the garden near to the house has a small well-maintained area, which is very pretty. Service users and staff have planted flowers and shrubs. The garden area directly in front of the wooden seat, and the surrounding area is Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 17 uneven and a possible danger. The bench should not be used until a risk assessment has been completed regarding the possible level of hazard. Health and safety documentation relating to all aspects of fire were found to be up-to-date and of a satisfactory standard. Fire alarms are tested weekly and fire drills on a monthly basis. Furzehill Road (9) DS0000019392.V300227.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): 33,34 and 35 The home operates a robust recruitment process which should provide confidence and protection to service users. Staff have appropriate skills and experience to respond to individual needs. The quality in this outcome group is good; this judgement has been made using all available evidence including a visit to this service. EVIDENCE: The files of two new employees were inspected. They contained all the appropriate security and identity checks including Criminal Records Bureau disclosures and two current references. The acting manager has worked hard to ensure staff have been recruited to the vacant posts discussed at the previous inspection. Records seen demonstrated that the induction process is very comprehensive providing clarity of staff roles and responsibilities. All care staff are provided with the opportunity to complete the N.V.Q Level 2 qualifications in care. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 19 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 and 42 The policies and procedures relating to recruitment meet the requirements of the National Minimum Standards, and care homes regulations. The home now has a permanent number of staff making the use of agency staff rare. EVIDENCE: The service has been without a registered manager for the previous three inspections. Susan Sears has been acting up for the past two inspections. Over this period of time she has made every effort to meet the requirements made at each inspection. Feedback from staff has been very positive about the support received from the acting manager, and her immediate manager. A new manager as been appointed and should be in post shortly. The CSCI would wish to be advised once he has started employment, and the provider should ensure that registration with the Commission is completed has soon as possible. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 20 The standard of care offered within the home is good; both in the delivery of care, and the recording of information. As previously stated, care plans have improved but further work is required both with regard to consistency and the process of reviewing information. The manager advised that Mencap provide good training opportunities from induction through to management. Many of the current team are working towards N.V.Q 3 or will register once they have completed induction training. The training planner was seen at this inspection and provided a very satisfactory plan of training attended and organised. Since the last inspection care staff have been recruited, including bank staff to cover for training and annual leave. Difficulties in providing cover, which was seen at the last inspection, should therefore no longer be such an issue. As previously stated under the section of the report relating to the environment, the garden area directly in front of the wooden seat, and the surrounding area is uneven and a possible danger. The bench should not be used until a risk assessment has been completed regarding the possible level of hazard and how it can be minimised. There were also several maintance issues within the house and the manager should ensure regular checks are carried out. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 21 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 2 25 X 26 X 27 X 28 2 29 X 30 3 STAFFING Standard No Score 31 X 32 X 33 3 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 X 4 X LIFESTYLES Standard No Score 11 X 12 4 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 22 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard YA6 Regulation 15(1) Requirement The service must ensure that an up to date and complete care plan is in place for each service user, and this is kept under review. (This standard has not been fully met) The fan and light in the kitchen area requires to be cleaned, and in full working order. Equipment provided at the home for use by service users must be maintained in good working order. (Downstairs toilet seat) The external grounds must be kept tidy, safe and accessible for service users to use without the risk of possible harm. (Garden area in front of the bench) The bench should not be used until a risk assessment has been completed regarding the possible level of hazard and how this hazard will be minimised or eliminated. Timescale for action 01/09/06 2. 3. YA24 YA24 23(2)(c) 23 (2)(c) 31/07/06 31/07/06 4. YA28 23(2)(b) 31/10/06 Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 23 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 YA6 Good Practice Recommendations The service must ensure that an up to date person centred plan is in place for all service users. Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 24 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 © 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 Furzehill Road (9) DS0000019392.V300227.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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