Inspection on 05/08/05 for Haddon (52A)

This inspection was carried out on 5th August 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Haddon (52A) 22/08/08

Haddon (52A) 21/08/07

Haddon (52A) 10/04/06

Haddon (52A) 04/10/05

Haddon (52A) 16/01/04

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Hillview Farm

Dalewood Respite Care

Orchard,The

REACH Upton Court Road

Fairways

Treloar College

Kestrel House, St Anne`s Opportunity Centre,

Pinta

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

CARE HOME ADULTS 18-65 Haddon (52A) Great Holm Milton Keynes Bucks MK8 9HP Lead Inspector Barbara Mulligan Unannounced 5 August 2005 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. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Haddon (52A) Address Great Holm, Milton Keynes, Bucks, MK8 9HP 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) 01908 230100 MacIntyre Care Elaine Forbes Care Home 15 Category(ies) of Learning disability (15) registration, with number of places Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: none Date of last inspection 30th December 2004 Brief Description of the Service: Set on the edge of Great Holm, 52A Haddon, owned by Macintyre Care, is located within a campus style complex, in amongst private housing. It provides accommodation to adults with learning disabilities. 52A Haddon is situated within walking distance of the local shops, church and local pubs. The building itself contains five self contained flats and a small garden area. There is a further complex of buildings that comprise of numbers. 42A and no. 32A Haddon, the organisations day care services, a hall, a nursery and garden centre, a craft shop, a coffee shop and a bakery. The coffee shop and bakery occupy the corner of the site and this provides occupational opportunities for service users and enables local residents to visit the shop. The nursery, garden centre and craft shop also provide occupational activities for service users and are open to the public.The centre of Milton Keynes is close by, offering a large shopping centre, cinema, a range of restaurants and recreational activities, cycle tracks and many other attractions. Service users are encouraged and supported to use public transport to which they have access. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 5th August 2005 at 10.30am on a Friday morning. The visit consisted of discussions with support workers and records, policies and procedures were examined. The registered manager was not on duty during the visit to the unit. What the service does well: What has improved since the last inspection? What they could do better: The staff team are caring and motivated but their numbers need to be increased if they are to fully meet the health care and social care needs of individuals. Staff training needs to be brought up to date for all relief staff and the unit needs to be staffed sufficiently to allow staff time off to attend necessary training. The registered provider needs to ensure that relief staff have an identified line manager who will be responsible for their formal supervision, annual appraisals and for putting relief staff forward for essential training. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 6 Serious consideration needs to be given to providing service users with comprehensive, accessible, understandable and up to date information, in a suitable format about policies, procedures, activities and services. There was no evidence that work has been carried out in this area and there was nothing available to look at. 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. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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 Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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) 2, 4 and 5. Prospective service users have the opportunity to visit the home on an introductory basis, before making a decision to move there, ensuring that service users are able to make an informed choice about where they live. Each service user has an individual written statement of terms and conditions with the home that needs to be signed by service users, relative or relevant third party and the registered manager to ensure the rights of service users are protected. EVIDENCE: A request was made for copies of the units Statement of Purpose and Service Users Guide. Staff were unable to find these during the visit and these will be reviewed during the next inspection. No service users have been admitted to 52A Haddon during the previous twelve months. The initial assessment tool is called “Moving into Macintyre Care” and is very comprehensive and detailed. This is dated June 2003. Pictures are included alongside written information to enable the potential service users to understand the process. The home has a policy called “Moving in and Moving out guidelines”. This is dated June 2003. This gives details of trial visits to the unit, day-to-day Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 9 support service users can expect and details of how and when a review of the placement will occur. This is not in a format suitable for service users. The inspector looked at service users contracts/statements of term and conditions. These covered all areas detailed in Standard 5. The home does not take emergency admissions nor is intermediate care offered. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 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 standard(s) These standards were not assessed during this inspection. EVIDENCE: Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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) These standards were not assessed during this inspection. EVIDENCE: Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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) 19 and 21. The physical, emotional and health care needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. Service users and their families are treated with respect and sensitivity at the time of their death. EVIDENCE: Service users are supported and facilitated to manage their own healthcare where practicable. Individuals visit their G.P. on a needs only basis. Service users access chiropody services locally. Specialist service such as physiotherapy can be accessed via a referral through the G.P. or via the Community Team for People with Learning Disabilities. Staff provide support to service users needing to attend outpatient and other appointments. If a service user became ill, an assessment would be carried out, with the involvement of their family, and the service users wishes regarding terminal care and death would be discussed, and carried out. A set of guidelines regarding the death of a service user is available and this is dated April 2004. These guidelines include the expected, sudden or unexpected death of a service user and a last wishes questionnaire. Service users with deteriorating conditions or dementia will be referred to their G.P. or the Learning Disabilities Community Team for personal support or technical aids. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 13 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 and 23. The unit has an effective complaints procedure to ensure that service users or their representatives are listened to. Staff have a good knowledge and understanding of Adult Protection issues which protect service users from abuse. However relief staff spoken to stated that they had not received any training regarding the protection of vulnerable adults and this needs to be implemented as soon as possible. EVIDENCE: There is a complaints procedure dated March 2003. This is in pictorial/photo form in the staff office and flats. A summary of the complaints procedure is included in the statement of purpose and service users guide. This includes information on how to refer a complaint to the commission. The home has a dedicated book for the recording of complaints. The home has not received any complaints since the previous inspection. All complaints are reviewed monthly and these are sent to the central office. The home use the Milton Keynes “Protecting Vulnerable Adults from Abuse” policy and a MacIntyre Care policy called “Protecting Vulnerable Adults from Abuse” dated September 2003 There were guidelines for staff about the responsibilities of the staff, types and signs of abuse and what to do if you suspect abuse. There is a public disclosure policy dated Sept 2003. Staff spoken to were aware of how to report any suspected abuse and were also aware of when it would be necessary to disclose information given to them in confidence. All permanent staff receive training about Adult Abuse and this forms part of their induction. However, during discussions with staff it was apparent that Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 14 relief staff do not attend regular training regarding the Protection of Vulnerable Adults and this will be a requirement of the report. There is a Whistle Blowing policy and a Physical Intervention Policy dated September 2002. The homes policies regarding service users money and financial affairs ensure service users access to their money, valuables and safe storage is safe guarded. There is a gifts procedure that provides staff with guidelines about receiving personal gifts from service users. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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) These standards were not assessed during this inspection. EVIDENCE: Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.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) 31, 32, 33, 35 and 36. Service users benefit from a staff team who are mostly up-to-date with their training, however relief staff need to undertake some updating of training to ensure that staff are competent to do their jobs. Service users benefit from clarity of staff roles and responsibilities ensuring continuity of care. Only limited progress has been made in addressing staffing shortages and as a result there had been some staff turnover and sickness that does not offer consistency of care to the people using this service. EVIDENCE: Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 17 Staff are aware of the homes/organisations values, policies and procedures through staff training and induction, reading policies and procedures which staff sign a form to say they have read. This form is then sent to the central office. The unit operates a link worker system. New staff work alongside more experienced staff until they become competent in their role. All staff are aware of the Learning Disabilities Community Team and how to contact them for advice. The unit has no volunteers at the time of the inspection. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 18 New staff undertake an induction to the unit and the organisation which provides the staff member with a personal development portfolio and the inspector saw evidence of this. This covers areas regarding understanding physical and verbal aggression and self harm, cultural and religious needs and the role of the multi-disciplinary team. Further training for staff includes First Aid, Basic Food Hygiene, Moving and Handling and Fire Awareness. However, in discussions held with staff it was apparent that training was not updated regularly for relief staff and this will be a requirement of the report. In discussions with staff it was apparent that relief staff did not have an identified line manager who was responsible for their formal supervision, annual appraisals and for ensuring that their training was up to date. This will be a requirement of the report. Records demonstrate that no staff members were under the age of 18 yrs. The head of service is required to assist at a supported living scheme on site which the head of service oversees. There is another supported living scheme that the head of service has responsibility for. The low level of staffing at 52A Haddon and having to oversee two supported living schemes the head of service was unable to undertake her role adequately and sufficiently. This was identified at the previous unannounced inspection and a requirement was made that the head of service is either made supernumerary at 52A Haddon to allow for time spent at the other schemes, or the registered manager is only responsible for one establishment. This has not been complied with and will be a requirement of this report. At the time of the visit the senior support worker was working in another home as acting Head of Service and another care wore worker was on maternity leave. Staff rotas demonstrate that care staff regularly work at a supported living scheme and the rotas also identified that care hours allocated for 52A Haddon are being utilised at the supported living scheme causing a deficiency in care hours. It is a requirement of the report that established care hours identified for 52A Haddon are utilised in this unit. Staffing levels are not adequate to provide support to service users with evening activities or adequate support at the weekend when service users are at home The rotas also showed that there were difficulties allowing staff time off for annual leave or covering staff sickness. Agency staff are used on a regular basis. This does not provide consistency of care for service users. It is recommended that serious consideration needs to be given to increasing the staffing ratios in the unit to allow staff to fully meet the needs of service users. Following the previous unannounced inspection a requirement was made that the head of service is either made supernumerary at 52A Haddon to allow for time spent at the other schemes, or the two supported living schemes are relinquished by the head of service. This requirement has not been complied with and will be requirement of this report. Discussions held with staff confirmed that staff meetings held fortnightly. There is evidence that care staff receive formal supervision monthly. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 19 All staff receive an appraisal with their line manager to review performance against job descriptions and agree development plans and this was confirmed in discussions held with staff. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 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) These standards were not assessed during this inspection. EVIDENCE: Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 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 CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score x 3 x 3 3 Standard No 22 23 ENVIRONMENT Score 3 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 LIFESTYLES Score x x x x x Score Standard No 24 25 26 27 28 29 30 STAFFING Score x x x x x x x Standard No 11 12 13 14 15 16 17 x x x x x x x Standard No 31 32 33 34 35 36 Score 3 3 2 x 3 3 CONDUCT AND MANAGEMENT OF THE HOME PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Haddon (52A) Score x 3 x 3 Standard No 37 38 39 40 41 42 43 Score x x x x x x x 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 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 23 Regulation 18 &13 Requirement The registered manager is required to enssure that all relief staff attend or update protection of vulnerable adults training and this is updated twice a year. The registered manager is required to ensure that all relief staff attend and update all mandatory training as necessary. The registered provider is required to ensure that staffing hours allocated for 52 A Haddon are utilised in this unit and not in another establishment. The registered provider is required to ensure that the head of service is either made supernumerary at 52A Haddon to allow for time spent at the other schemes, or the two supported living schemes are relinquished by the head of service. (Previous timescale of 30.06.05 not met.) The registered provider is required to ensure that all relief staff have an identified line manager who will be responsible for ensuring that relief staff recieve supervision, annual Timescale for action 30/12/05 2. 35 18 30/02/05 3. 33 18 30/09/05 4. 33 18 30/09/05 5. 36 18 30/10/05 Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 23 appraisals and all essential training is undertaken. 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. 2. Refer to Standard 33 Good Practice Recommendations It is recommended that serious consideration needs to be given to increasing the staffing ratios in the unit to allow staff to fully meet the needs of service users. Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 Page 24 Commission for Social Care Inspection 8 Bell Business Park Smeaton Close, Aylesbury Buckinghamshire HP19 8JR 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 Haddon (52A) 20050805 52a Haddon X00023 UI S39068 V248878 H53.doc Version 1.40 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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