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Inspection on 22/06/06 for Long Furrows

Also see our care home review for Long Furrows for more information

This inspection was carried out on 22nd 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

From evidence gathered over previous inspections the home continues to provide a consistently good standard of care. Service users continue to be supported in an environment that is homely, whilst at the same time being equipped well to meet their assessed needs. Staff were very supportive of service users and appeared to have a good understanding of their needs; interactions seen and heard were positive and respectful in nature. A group discussion held with several staff evidenced that they continued to feel well supported by the management team, who they described as being readily assessable and easily approachable. All felt that the management team provided them with a clear sense of leadership and direction. Staff confirmed that access to training continues to be good. Staff spoke of formal supervision being provided every six to eight weeks. When asked what the service could do better or differently staff stated that they believe the service provided by the home to be very good.

What has improved since the last inspection?

No requirements or recommendations were made from the previous inspection, however since that inspection the home has been in the process of a significant amount of redecoration. Evidence was seen of this process being ongoing, both within communal areas and service users` rooms. During the tour of the premises the registered manager pointed out a number of rooms which had been identified for refurbishment.

What the care home could do better:

Evidence from this inspection, including comments made by staff, indicates that there is currently nothing that the home could do to make further improvements, although the manager is always keen to try out anything new that will directly benefit the service users. The ethos of the home is one of continual improvement, and evidence suggests that only the best is good enough.

CARE HOME ADULTS 18-65 Long Furrows 4 Long Road Mistley Manningtree Essex CO11 2HN Lead Inspector Neal Cranmer Unannounced Inspection 22nd June 2006 09:30 Long Furrows DS0000017871.V300459.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 Long Furrows DS0000017871.V300459.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. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Long Furrows Address 4 Long Road Mistley Manningtree Essex CO11 2HN 01206 392634/391488 01206 391695 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) Mr M Volf Mrs J Volf Mrs Shirley Ann Bendall Care Home 14 Category(ies) of Learning disability (14), Physical disability (14) registration, with number of places Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home accommodates 14 people with learning disabilities who may also have physical disabilities 14th February 2006 Date of last inspection Brief Description of the Service: Long Furrows provides a service to people with learning and physical disabilities. The home is a detached building situated next door to another home (Little Manor), which is also owned and operated by the same provider. It has 13 bedrooms, 12 of which are single, the majority benefiting from en-suite facilities. A passenger lift services the bedrooms on the first floor. There are two separate bathrooms, the one on the ground floor being equipped with a specialist bath. The home benefits from two lounges, a conservatory and a separate dining room on the ground floor. There is also a multi-sensory room equipped with a variety of sensory stimulation equipment. In addition, the home has a computer room which is accessible to all service users. Discussion with the registered manager at the time of the inspection indicated that the fee range for the home is between £2,260 per month and £6,316 with additional charges being made for the following: • • • • Chiropody Hairdressing Toiletries Activities and holidays. To the rear of the property there are extensive grounds which are readily accessible to service users. At the front of the premises there is ample parking space for vehicles. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced inspection to Long Furrows which took place on the 22nd June 2006, the first inspection to the home for the year 2006/2007. The registered manager was available at the home throughout the course of the inspection. The fieldwork visit to the home was carried out between the hours of 09:15 and 15:00. The inspection included discussions with the registered manager, staff and service users, although the latter was limited due to the level of service users’ ability. Nevertheless, observation of service users in their environment evidenced that they were happy, content and relaxed. In addition to these discussions and observations, a range of documentary records and files was sampled. A total of twenty of the forty-three standards were inspected, of which one was exceeded, with the remainder all being met. A tour of the premises was undertaken which evidenced that the home was decorated and maintained to a high standard. The premises were equipped with a range of aids and adaptations designed to meet the needs of service users. What the service does well: From evidence gathered over previous inspections the home continues to provide a consistently good standard of care. Service users continue to be supported in an environment that is homely, whilst at the same time being equipped well to meet their assessed needs. Staff were very supportive of service users and appeared to have a good understanding of their needs; interactions seen and heard were positive and respectful in nature. A group discussion held with several staff evidenced that they continued to feel well supported by the management team, who they described as being readily assessable and easily approachable. All felt that the management team provided them with a clear sense of leadership and direction. Staff confirmed that access to training continues to be good. Staff spoke of formal supervision being provided every six to eight weeks. When asked what the service could do better or differently staff stated that they believe the service provided by the home to be very good. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 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. Long Furrows DS0000017871.V300459.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 Long Furrows DS0000017871.V300459.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. Quality in this outcome area is excellent. This judgement has been made using available evidence, including a visit to this service. There is a very comprehensive process for ensuring that prospective service users’ individual needs and aspirations are assessed. EVIDENCE: Four service users’ files were sampled. Each had in place a very comprehensive needs assessment completed by a representative of the home. The assessments were seen to cover the following areas of need: • • • • • • • Physical mental health care needs Assessment and management of risk Family/social contact Method of communication Cultural and faith needs Likes/dislikes Medication. From the comprehensive needs assessment the home then develops an individual care plan. Long Furrows DS0000017871.V300459.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, & 9. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users’ needs and goals are reflected in their plans of care, and they are supported to make decisions about their lives. Evidence was seen of risk assessments being undertaken. EVIDENCE: Care plans are developed from the comprehensive needs assessments completed by the home. In particular, care plans had good information around service users’ personal care and how service users wished this to be carried out. The objectives set were clear and concise, as were the actions to be followed by staff in supporting the service users towards meeting the identified objectives. Review dates were seen to be set. Risk assessments are in place and are well detailed, clearly identifying the nature of the risk, the likelihood of its occurrence and steps to be followed by staff to minimise any presenting risk. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 10 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, & 17. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are supported to take part in a range of appropriate activities and are assisted to be part of the local community. The home works hard to ensure that family links are maintained. Service users rights are maintained. The home provides a varied and nutritious diet. EVIDENCE: One service user attends paid employment at a local business one morning a week where they are employed to carry out paper shredding. The home provides a range of fulfilling activities, evidence of which was seen posted on the board situated outside of the office area. This included: Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 11 • • • • • • • • Supported cooking Needlecraft Knitting Jigsaw puzzles Karaoke Painting and drawing Skittles Dough making Singing and dancing. On the day of the inspection a visitor was seen and heard at the home providing a sing-along session in which service users were seen and heard to be taking part. The home has a small, but well equipped, Snoezalen room, which has a range of sensory stimuli, soft play area and hammock chair. Discussion with staff indicated that service users are supported to access the community in a number of ways, e.g. • • • • • Meals out Visits to local garden centres Train spotting (one service user spoke at length of their interest in this subject and of being supported by staff to visit the local train station) Holidays Outings This was further evidenced through the viewing of records sampled at the time of the inspection. Discussion with the registered manager informed that the home has an open door policy on the receiving of visitors. Key workers support service users to maintain links through the sending of cards and letters. The registered manager spoke of visitors being welcome to have a meal whilst visiting the home. Service users are free to receive their visitors in the privacy of their own rooms or, if they wish, there is access to a quiet lounge or conservatory area. Meals are provided three times daily, at least one of which is cooked. In addition, suppers are provided. The registered manager reported that menus are designed on the basis of providing a range of different meals; observation then determines service users’ preferences which are then incorporated into future menus. The menu sampled for the week commencing 17/06/06 was seen to be varied and nutritious. On the day of the inspection the lunchtime meal was discreetly observed. Service users requiring assistance with eating were seen to be supported on a 1:1 basis; the mealtime was seen to take place in a relaxed and unhurried manner. Service users’ wishes were evidenced to be respected which was seen when a service user indicated a Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 12 dislike for an item of food on their plate. This was immediately replaced with a fresh plate of food with the offending item removed. The home also provides support to service users from an ethnic background. Evidence was seen within service users’ assessments which showed a distinct liking for spicy foods. The registered manager spoke of ensuring that opportunities are provided for service users to have spicy meals. Long Furrows DS0000017871.V300459.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, & 20. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. The home ensures that service users’ personal support is provided in the way they require, and that their physical and emotional needs are met. Service users are protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Care plans sampled provided staff with clear guidance about how service users wished to be supported with their personal care. On the day of the inspection staff were observed to maintain service users privacy and dignity when carrying out personal care. All service users are registered with a General Practitioner. Healthcare records are maintained very well with evidence of the following healthcare professionals providing input to the home being seen: Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 14 • • • • • • • • General practitioners Chiropodists Community Nurses Speech and language Therapists Music Therapists Dentists Optometrist Physiotherapists. Medication is dispensed via a measured dosage system and individually named containers. Medication is dispensed by senior carers who have all received training. Long Furrows DS0000017871.V300459.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 & 23. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Evidence suggests that service users can be confident that their views would be listened to and acted upon. The home has in place sound policies and procedures for ensuring that service users are protected from harm or abuse. EVIDENCE: The home’s complaints policy/procedure are robust and include timescales for resolving any complaints received. The home maintains a log for the recording of any complaints or compliments received. At the time of the inspection no complaints had been received by either the home or the Commission for Social Care Inspection. The home has a detailed policy on Adult Protection, which clearly lays out the procedure to be followed in the event of a suspected or actual case of abuse or neglect. Since the previous inspection one adult protection referral has been made by the home. All actions required by the home to undertake were appropriately actioned. Discussion with the registered manager evidenced that all staff have received training in adult protection and also reported the intention for all staff to receive in-house refresher training every six months. Long Furrows DS0000017871.V300459.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 & 30. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are supported in an environment that is homely, safe and maintained to a good standard. The home’s laundry facilities are adequate, and hygiene arrangements at the home are good. EVIDENCE: Tour of the premises was undertaken in the company of the registered manager. The home has been undergoing, and is continuing with a programme of redecoration. A number of service users’ bedrooms were seen to have been redecorated, as had the dinning room areas. The registered manager spoke of a number of service users’ rooms being due to be refurbished with fitted wardrobes. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 17 The premises are safe and well maintained, comfortable, bright and cheery. Furnishings and fittings were domestic in nature and were of a good quality. The premises are in keeping with the local community. The home is equipped with a laundry room that is situated away from food preparation areas. It is fitted with industrial style washing machines and dryers. A sluicing facility was available as were hand washing facilities. On the day of the inspection the home was found to be clean, tidy and free from any foul or unpleasant odours. Long Furrows DS0000017871.V300459.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): 32, 34, 35, & 36. Quality in this outcome area is good. This judgement has been made using available evidence, including a visit to this service. Service users are supported by an effective team of competent and qualified staff, who receive the appropriate level of support and supervision required to carry out their roles safely and effectively. Service users are protected by the home’s recruitment policy and procedure. Evidence indicated that staff receive appropriate training. EVIDENCE: Figures submitted in the Pre-Inspection Questionnaire show that of twenty five care staff fifteen are qualified at N.V.Q level two, this represents 60 of the care team. Four staff files were sampled in respect of the home’s recruitment practice. All records required under Regulation 19, Schedule 2 of the Care Homes Regulations were found to be in order. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 19 Discussion with staff indicated that access to training was good. The Pre-Inspection Questionnaire submitted showed that the following training had taken place in the last twelve months: • • • • • • • • • • First aid Manual Handling Infection control Food hygiene In-house protection of vulnerable adults Medication administration Rectal diazepam administration Health and safety training N.V.Q level 2. Registered managers award. The following information was also provided in respect of proposed future training: • N.V.Q Level 2 and 3. • Reiteration of above identified training. Staff spoke of receiving formal supervision every six to eight weeks, with the manager supporting the deputy manager and senior carers, who then supervise colleagues. Discussion with senior carers evidenced that they had not received any training in preparation for this role. Long Furrows DS0000017871.V300459.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 at least once during a 12 month period. 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. Overall the home is run well. The manager is qualified at N.V.Q level 4 in management and care. The home has in place a process for reviewing and keeping under review the quality of its service provision. The home ensures that the health, safety and welfare of service users are promoted and protected. EVIDENCE: The registered manager is qualified at N.V.Q level 4 in management and is in the process of awaiting their final four units in care to be verified. The registered manager continues to receive support from the proprietors to further develop their skills and knowledge. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 21 The home has in place a mechanism by which to measure the quality of its service provision, which includes the dissemination of questionnaires to seek the views of a range of interested stakeholders, including relatives, friends, doctors and community nurses. Records sampled during the inspection showed that water temperature checks are regularly kept. Maintenance records showed that fire equipment, emergency lighting, electrical wiring and hoists are in order and have been checked. Long Furrows DS0000017871.V300459.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 4 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 X 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 X 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 Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 23 No 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. 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. 1. Refer to Standard YA36 Good Practice Recommendations It is recommended that where staff are providing supervision to junior colleagues they receive training in preparation for this role. Long Furrows DS0000017871.V300459.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Long Furrows DS0000017871.V300459.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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