Inspection on 20/11/06 for Ivers

This inspection was carried out on 20th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Ivers 12/01/06

Ivers 12/09/05

Ivers 21/03/05

Ivers 21/01/05

Similar services:

2 Perhaver Park

The Vicarage

St George`s

5 Seafield Road

Credence House

Radfords

Honeybourne House

32 Beaumont Way

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 Ivers Hains Lane Marnhull Sturminster Newton Dorset DT10 1JU Lead Inspector Marion Hurley Key Unannounced Inspection 20th November 2006 09:30 DS0000026825.V300481.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 DS0000026825.V300481.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. DS0000026825.V300481.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Ivers Address Hains Lane Marnhull Sturminster Newton Dorset DT10 1JU 01258 820164 01258 820258 ivers.college@btinternet.com 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) Ivers House Limited Linda Anne Matthews Mr Peter Francis Cheesman Care Home 23 Category(ies) of Learning disability (23) registration, with number of places DS0000026825.V300481.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The number of persons for whom residential accommodation, with both board and personal care, is provided in the Home at any one time (excluding the persons carrying on or employed at the Home and their relatives) shall not exceed: Twenty-three (23) within the Category of LD (Learning Disability) being Twenty (20) at Ivers, Hains Lane and Three (3) at `Felicity`, Lovells Mead. 12th January 2006 Date of last inspection Brief Description of the Service: Ivers is registered as a care home for adults with a learning disability. Ivers provides a learning environment offering vocational and life skills training. The service users, known as students, are mainly aged between 18 and 35. Ivers is situated on the outskirts of Marnhull, a large village which includes such facilities as shops, pubs, a post office, church and GP surgery. On the main site there are three buildings, the original main house and two bungalows all within the grounds. One bungalow known as Trafalgar has ground floor accommodation and teaching rooms above and the new bungalow called Kenley has four large bed sitting rooms and a large communal kitchen/dining area. A small bungalow, accommodating three service users, is situated in the main part of the village, approximately half a mile away. The home admits young adults with a moderate learning disability who do not present severe challenging behaviour. Each year is divided into 4 terms, linked by short holiday periods when the majority of service users return to their own home. Ivers ethos is to promote and support all students who are able to be involved in communal work at Ivers or work in the local area. Products produced by the students are sold at local fund raising events. The following fees were confirmed by the registered manager as being current at the time of the inspection on November 20th, 2006. • Fees start from £800.00 per week with additional charges for students’ assessed as requiring additional staff time. The fees include personal care, accommodation and meals. There are no additional charges for day services. Chiropody and hairdressing services can be arranged and are charged separately. Other costs would include clothing and toiletries. DS0000026825.V300481.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. All standards identified as “key” standards and highlighted through the report were inspected. The key standards are those considered by the Commission to have a particular impact on outcomes for residents. Inspection of the standards was achieved through review of existing evidence, pre-inspection planning, an unannounced inspection visit to the home and drawing together all of the evidence gathered. The review of evidence and pre-inspection planning involved reviewing the report of the previous statutory inspection carried out in January 2006 and the service history, which details all contact with the home including notifications of events reported by the home. A pre inspection questionnaire submitted by the registered manager, and 12 comment cards from students and relatives/visitors were also reviewed. The unannounced inspection visit to the main site lasted approximately four hours and the visit to “Felicity” was undertaken on another day late in the afternoon /early evening and lasted approximately two hours. The inspection involved selecting care records of two students and tracking their care and experiences through review of the records, discussion with them, the care staff and observation of care practices. The inspector spoke to 13 students, some individually, and some in groups. Observations were made of students’ general well being, daily routines and interactions between staff and students. The management of students’ medication was reviewed. Staff training was discussed with staff and two files of newly recruited staff were reviewed to check the adequacy of the recruitment process. Some bedrooms were viewed and all communal areas and the inspector was shown the grounds and livestock during discussions with different students. Feedback on the inspection was given to students, staff and the registered manager throughout the inspection visit. What the service does well: One of the main strengths of the service is the support and encouragement students have to increase their skills and to lead fulfilling lives. Students spoken to on the day said they liked living at Ivers and “really enjoyed their jobs.” DS0000026825.V300481.R01.S.doc Version 5.2 Page 6 Most of the “jobs/work” are placements within Ivers and include gardening, laundry, kitchen, cleaning, car cleaning, animal welfare or working in the workshops producing goods for sale. The assessment process takes account of whether a prospective student would be able to benefit from and contribute to the life at Ivers. Students are involved as much as possible in determining how their care, health and support needs are met and encouraged to be as independent as possible. A student has recently been involved in the recruitment and interviewing process of new staff. Both members of staff and the student said how well this had worked and students would be involved regularly in the recruitment of staff. Staff and students are encouraged to raise concerns, which are taken seriously with action where necessary. Students regularly hold meetings and with staff support now manage the meeting, writing their own agenda, chairing the meeting and taking their minutes. Both staff and several students said how good the meetings were and people “are really listening to each other.” Accommodation is in four houses/bungalows, three of which are set in the large grounds of the main house. The fourth bungalow is located in the village. The gardens/ grounds are well maintained providing pleasant and spacious areas where students’ can spend time. The houses were clean and comfortable. Management reports are routinely sent to the Commission and continue to provide valuable information concerning all aspects of the services, facilities, students and staff living and working at Ivers. What has improved since the last inspection? Additional staff are undertaking a National Vocational Qualification to increase the number of staff with a care qualification. The new bungalow in the grounds on the main site has been completed to a high standard, though is currently not in use except as a training facility. However it is anticipated students will soon be occupying the four large bed-sit rooms all of which have en suite facilities and access the large communal kitchen/dining area. DS0000026825.V300481.R01.S.doc Version 5.2 Page 7 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. The summary of this inspection report can be made available in other formats on request. DS0000026825.V300481.R01.S.doc Version 5.2 Page 8 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 DS0000026825.V300481.R01.S.doc Version 5.2 Page 9 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The admission process provides assurances that students can make an informed choice about entering the home and that their needs can be met. EVIDENCE: A student told the inspector that they moved to Ivers for a “visit and then stayed” this infact was the introductory assessment stay. This gave them the opportunity to see if they wanted to move in to the home and for staff to see if it would be right for them and they would be able to meet their needs. The student felt they had been given enough information and time to make a choice and that the home met their expectations. The home has recently produced a new Statement of Purpose and Service User Guide, which provide written information about the services. A new student and family/carer handbook / brochure is currently being developed. DS0000026825.V300481.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students receive a good standard of care and support and are encouraged to make decisions about their lives. EVIDENCE: Questionnaires from students and relatives confirm they are happy with the overall care provided with many additional comments such as “we are very satisfied with the care” The care and support provided was discussed in detail with two students individually. Both showed the inspector their Care and Learning Plans and these were discussed with the support of their key workers. Both students confirmed that they are aware of the contents of their files and are encouraged to be as involved as possible with drawing up their plans. The discussions with the students about their care and learning plans demonstrated that students are in control of their care and decide how they wish staff to support them. DS0000026825.V300481.R01.S.doc Version 5.2 Page 11 The plans include goals, which students want to achieve, and the support they need to do that. The students had signed all the plans, which were looked at during this inspection visit. The plans are reviewed monthly with the student and their keyworker and then more formally every six months. In addition to the Care and Learning Plans daily notes are maintained describing any trips, activities participated in and general reflections on daily routines and the student’s living skills. DS0000026825.V300481.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Opportunities for personal development are provided and students are encouraged to lead a busy and fulfilling life. EVIDENCE: Students told the inspector that they have a very busy life and enjoy working “like other people”. There is an expectation that all the students engage in some kind of work or creative activity. Students advised they can choose the type of work they do. Examples of the work include gardening, cleaning vehicles, helping with the kitchen, helping with the animals, recycling or working in the workshops where various items such as scarves, and aprons are made for sale at local events. Responses in questionnaires from visitors / relatives confirmed that they are made welcome in the home and that their visiting arrangements are flexible. DS0000026825.V300481.R01.S.doc Version 5.2 Page 13 Students spoken to confirmed that they were happy living at Ivers and really enjoyed themselves doing all “the different things”. Students said they went shopping in the village or to the larger towns. A variety of holidays have been enjoyed by many of the students this year including a trip to France, one to Ireland and some went on a narrow boat holiday. In addition to the holidays Ivers has a special Activity week when students are given opportunities to chose different activities or venues to visit. Other events have included a successful barbecue and folk evening, a drumming event and the summer fete raised £1500. The quality of the meals provided is exceptionally high and Ivers benefits from a very good cook who clearly enjoys producing varied and interesting meals for the students. The menu is displayed in the dining room and there is always two choices everyday plus a vegetarian option. In addition there is a full range of homemade deserts. Students take it in turns to work in the kitchen and to serve the meals. This task is completed as in a restaurant with the student taking “orders” from each table. The home uses much of its own home reared meat and other supplies are purchased locally. All records associated with the kitchen were being maintained i.e. temperature of appliances, cleaning rota. All the students commented on the quality of the meals saying they liked the food and that they were always able to make their own drinks or get snacks if they wanted to. Ivers often holds “dinner parties” for the students and their guests and these are very popular with everyone. DS0000026825.V300481.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Students receive a good level of care and support based on their individual needs and preferences, with healthcare services accessed as required. EVIDENCE: As identified under the section titled “individual needs and choices” students are in control of their care. A student described how their care and support needs had been detailed in their care plan which demonstrated that the aim is to help students be as independent as possible which includes personal care. A student spoken to had full insight into their health care needs and confirmed that the relevant health care and advice is available. All arrangements and appointments are carried out with their full involvement. During a sample check of the management of students’ medication it was apparent that students are aware of their medication and involved in any discussions. A sample check of the medication system confirmed that there is a clear system in place for the management and recording of medication administration. No discrepancies were identified in the sample check. DS0000026825.V300481.R01.S.doc Version 5.2 Page 15 All “remedies” are well documented and had been agreed by the GP. Details from the medication charts could be cross-referenced with daily notes i.e. if a student had a headache and was given a remedy this was recorded. Information from health care professional questionnaires confirms that they are satisfied with the care provided, that staff communicate clearly with them and that they demonstrate a clear understanding of students’ needs. DS0000026825.V300481.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There are procedures in place for dealing with concerns and complaints which students’ and relatives /visitors are aware of. Complaints are taken seriously and where necessary action is taken. EVIDENCE: The Commission for Social Care Inspection have received no complaints about the service since the last inspection. Staff and students are encouraged to raise concerns and both staff and students when independently asked said any concerns/complaints were taken seriously and action taken. Students had no concerns about how they are treated by staff though some raised comments about other students. Discussions with students and staff during the inspection confirmed that students speak to staff if they are not happy with anything and that when situations arise staff deal with the situation. Staff spoken to had no concerns about how students’ were being treated and were aware of their responsibilities to act to protect students. DS0000026825.V300481.R01.S.doc Version 5.2 Page 17 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The standard of the environment is good providing students with a clean comfortable and homely place to live, which meets their needs. EVIDENCE: Students’ accommodation is provided in four houses, each with its own kitchen /dining and sitting areas. The communal areas in all three houses were seen, all were clean and comfortable. Students move freely around the site and all said they were happy with their bedrooms and the facilities. DS0000026825.V300481.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. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 & 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff training, recruitment procedures and staffing levels provide good care and protection for students. EVIDENCE: Strafing levels were discussed with the registered manager who advised that these are tailored to the assessed needs of students. Discussion with staff and students and questionnaires from relatives confirm that there are enough staff to meet students’ needs. Observations confirmed this was the case at the time of the inspection. Records reviewed of two recently recruited staff confirm that there is a thorough recruitment process in place, which indicates obtaining references and a satisfactory criminal records bureau clearance prior to someone starting work in the home. The pre-inspection questionnaire submitted by the registered manager identified a total of 18 staff having achieved a National Vocational Qualification (NVQ) at level 2 or above. DS0000026825.V300481.R01.S.doc Version 5.2 Page 19 Additional training to meet students’ needs have included topics such as; homes caring for autism, communication/signing, partners in care, and age discrimination. A staff member confirmed that staff are supported in their work with students and have regular supervision sessions. DS0000026825.V300481.R01.S.doc Version 5.2 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 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management and organisation of the home is good promoting the interests and well being of students. EVIDENCE: The registered manager was available throughout the inspection visit however the inspector spent most of the time with students and staff. The pre-inspection questionnaire confirms that regular servicing and maintenance checks on the premises and equipment are carried out. Staff confirmed that they receive appropriate training in safe working practices such as health and safety, movement and handling, basic food hygiene and first aid. DS0000026825.V300481.R01.S.doc Version 5.2 Page 21 Fire records are extremely thorough and very well maintained. Regular staff meetings are held twice a term and policies and procedures are discussed at this forum. A care practice group meet twice a term and this group focus on student’s needs and aspirations, shift leaders formally meet twice a term and each shift has a formal handover with clearly identified staff taking the lead responsibility for delegated tasks. i.e. medication. DS0000026825.V300481.R01.S.doc Version 5.2 Page 22 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 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 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 DS0000026825.V300481.R01.S.doc Version 5.2 Page 23 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. Standard Regulation Requirement Timescale for action 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 DS0000026825.V300481.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Poole Office Unit 4 New Fields Business Park Stinsford Road Poole BH17 0NF National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 DS0000026825.V300481.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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!